{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T14:15:56Z","timestamp":1781360156184,"version":"3.54.1"},"reference-count":0,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[1997,6,1]],"date-time":"1997-06-01T00:00:00Z","timestamp":865123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1997,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The objective of this study was to determine the morbidity associated with trocar and needle insertion for\nlaparoscopic surgery and to identify risk factors for complications. Data from a prospectively collected database of all laparoscopic\noperations performed at a major teaching hospital over a 4\u2010year period\nwere analyzed. In 203 patients closed laparoscopy (Veress needle plus\nblind trocar insertion) was used to establish the pneumoperitoneum. Open laparoscopy with a Hasson's trocar was performed in 200 patients. A total of 1206 operative trocars were inserted (mean \u00b1 SD\n2.99 \u00b1 0.4). Sixty\u2010nine percutaneous punctures for\ncholangiography or liver biopsy were carried out. Of the 403 patients\nundergoing laparoscopic surgery, 20 (5%) had developed complications\nspecifically related to the access to the abdominal cavity after a\nminimum follow\u2010up of 3\u00a0months, abdominal wall hematoma being the most\nfrequent (<jats:italic>n<\/jats:italic>= 8, 2.0%), followed by umbilical hernias (<jats:italic>n<\/jats:italic>= 6, 1.5%) and umbilical wound infection\n(<jats:italic>n<\/jats:italic>= 5; 1.2%). The rate of penetrating injuries was\n0.2% (<jats:italic>n<\/jats:italic>= 1). Of 20 complications, 15 (75%) were\nrelated to the umbilical insertion site. Female sex and closed\nlaparoscopy were associated with umbilical morbidity by univariate\nanalysis. In a multivariate analysis, closed laparoscopy was the only\nfactor associated with these complications (odds ratio = 6.0;<jats:italic>p<\/jats:italic>= 0.04). Age, gender, obesity, diabetes mellitus, previous abdominal surgery, and the specific procedure had no\ninfluence. In conclusion, gaining access to the peritoneal cavity for\nlaparoscopic surgery may cause severe complications, most of which are\nrelated to the umbilical trocar. Although closed laparoscopy can be\nsafely used, open laparoscopy is associated with a lower morbidity\nrate; therefore its utilization is recommended.<\/jats:p>","DOI":"10.1007\/pl00012281","type":"journal-article","created":{"date-parts":[[2006,2,17]],"date-time":"2006-02-17T17:42:42Z","timestamp":1140198162000},"page":"529-533","source":"Crossref","is-referenced-by-count":183,"title":["Risks of the Minimal Access Approach for Laparoscopic Surgery: Multivariate Analysis of Morbidity Related to Umbilical Trocar Insertion"],"prefix":"10.1002","volume":"21","author":[{"given":"Julio","family":"Mayol","sequence":"first","affiliation":[{"name":"Department of Surgery I Hospital Universitario San Carlos C\/Martin\u2010Lagos S\/N 28040 Madrid Spain<!--<country1>ES<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Garcia\u2010Aguilar","sequence":"additional","affiliation":[{"name":"Department of Surgery I Hospital Universitario San Carlos C\/Martin\u2010Lagos S\/N 28040 Madrid Spain<!--<country1>ES<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ortiz\u2010Oshiro","sequence":"additional","affiliation":[{"name":"Department of Surgery I Hospital Universitario San Carlos C\/Martin\u2010Lagos S\/N 28040 Madrid Spain<!--<country1>ES<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"De\u2010Diego Carmona","sequence":"additional","affiliation":[{"name":"Department of Surgery I Hospital Universitario San Carlos C\/Martin\u2010Lagos S\/N 28040 Madrid Spain<!--<country1>ES<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus A.","family":"Fernandez\u2010Represa","sequence":"additional","affiliation":[{"name":"Department of Surgery I Hospital Universitario San Carlos C\/Martin\u2010Lagos S\/N 28040 Madrid Spain<!--<country1>ES<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[1997,6]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/PL00012281.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/PL00012281\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/PL00012281","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T16:01:38Z","timestamp":1704988898000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/PL00012281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,6]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1997,6]]}},"alternative-id":["10.1007\/PL00012281"],"URL":"https:\/\/doi.org\/10.1007\/pl00012281","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[1997,6]]}}}