Authors' objectives:

This aim of this report was to assess the safety of open versus closed technique for laparoscopy.

Authors' recommendations: - We identified one systematic review and one randomised controlled trial (RCT) that directly compared the Veress needle and Hasson techniques for laparoscopy. - The studies assessed the following outcomes: death, visceral injury, vascular injury, gas embolism, wound infection, time to complete procedure, successful completion of procedure and gallbladder abnormalities. - Both studies concluded that the open laparoscopic technique is safer than the closed technique. - The RCT concluded that the open technique is faster to perform than the closed technique. - The systematic review reported lower incidence of vascular injury for the open technique. the RCT reported lower rates of major complications, and higher rates of wound infection with the open technique. There were no significant differences in death rates, visceral injury, gall bladder abnormalities, or successful completion of procedure. - The RCT lacked blinding and had a small sample size. The systematic review had a narrow search strategy, included only low-level studies, and did not assess the quality of the included studies.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.med.monash.edu.au/healthservices/cce/evidence/

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Centre for Clinical Effectiveness

Contact Address: Monash Institute of Health Services Research, Block E, Monash Medical Centre, Locked Bag 29, Clayton, Victoria 3168, Australia. Tel: +61 3 9594 7505; Fax: +61 3 9594 7552.

Contact Name: cce@med.monash.edu.au.

Contact Email: cce@med.monash.edu.au.

Copyright: Centre for Clinical Effectiveness (CCE)