{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,15]],"date-time":"2025-02-15T05:07:34Z","timestamp":1739596054125,"version":"3.37.1"},"reference-count":13,"publisher":"Galenos Yayinevi","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facts Views Vis ObGyn"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:p>Despite the majority of laparoscopic visceral injuries occurring with primary entry, high-fidelity training models are lacking.\n\nThree healthy volunteers underwent non-contrast 3T MRI at Edinburgh Imaging. A direct entry 12mm trocar was filled with water to improve MR visibility, placed on the skin at entry points, then images were acquired in the supine position. Composite images were created, and distances from the trocar tip to the viscera were measured, demonstrating anatomical relationships during laparoscopic entry.\n\nWith a BMI of 21 kg\/m2, gentle downward pressure during skin incision or trocar entry reduced the distance to the aorta to less than the length of a No. 11 Scalpel blade (22mm). The need for counter-traction and stabilisation of the abdominal wall during incision and entry is demonstrated.\n\nWith a BMI of 38 kg\/m2, deviating from the vertical angle for trocar insertion can result in the entire trocar shaft being placed within the abdominal wall without entering the peritoneum, creating a \u2018failed entry.\u2019 At Palmer\u2019s point distance between the skin and bowel is only 20mm. Ensuring the stomach is not distended will minimise gastric injury risk. The use of MRI to provide visualisation of the critical anatomy during primary port entry allows the surgeon to gain better understanding of textually described best practice techniques.<\/jats:p>","DOI":"10.52054\/fvvo.15.2.061","type":"journal-article","created":{"date-parts":[[2023,7,9]],"date-time":"2023-07-09T13:16:06Z","timestamp":1688908566000},"page":"145-151","source":"Crossref","is-referenced-by-count":0,"title":["MRI enhances the understanding of critical anatomy during primary laparoscopic port placement"],"prefix":"10.52054","volume":"15","author":[{"given":"E.A.","family":"Layden","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.R.","family":"Chodankar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.E.","family":"Kershaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Madhra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2811","published-online":{"date-parts":[[2023,6]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Ahmad G, Baker J, Finnerty J et al. Laparoscopic entry techniques. Cochrane Database Syst Rev. 2019;1:CD006583.","DOI":"10.1002\/14651858.CD006583.pub5"},{"key":"ref1","unstructured":"Merlin T, Jamieson G, Brown A, et al. A systematic review of the methods used to establish laparoscopic pneumoperitoneum. 2001. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK), https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK68860\/"},{"key":"ref2","unstructured":"Dingfelder JR. Direct laparoscopic trocar insertion without prior pneumoperitoneum. J Reprod Med. 1978;21:45-7."},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Garry R. A consensus document concerning laparoscopic entry techniques. Gynaecol Endosc. 1999;8:403-6.","DOI":"10.1046\/j.1365-2508.1999.00309.x"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Garry R. Towards evidence-based laparoscopic entry techniques: clinical problems and dilemmas. Gynaecol Endosc. 2001;8:315-26.","DOI":"10.1046\/j.1365-2508.1999.00310.x"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Harkki-Siren P, Kurki T. A nationwide analysis of laparoscopic complications. Obstet Gynecol. 1997;89:108-12.","DOI":"10.1016\/S0029-7844(96)00390-0"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Hasson HM. Open laparoscopy as a method of access in laparoscopic surgery. Gynaecol Endosc. 2001;8:353-62.","DOI":"10.1046\/j.1365-2508.1999.00316.x"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Jansen FW, Kapiteyn K, Trimbos-Kemper T et al. Complications of laparoscopy: a prospective multicentre observational study. Br J Obstet Gynaecol. 1997;104:595-600.","DOI":"10.1111\/j.1471-0528.1997.tb11539.x"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Jones KD, Fan A, Sutton CJG. Safe entry during laparoscopy: a prospective audit in a district general hospital. Gynaecol Endosc. 2002;11:85-9.","DOI":"10.1046\/j.1365-2508.2002.00498.x"},{"key":"ref9","unstructured":"Penfield AJ. How to prevent complications of open laparoscopy. J Reprod Med. 1985;30:660-3."},{"key":"ref10","unstructured":"Pierre F, Chapron C, Harchaui Y et al. French survey on gynaecological major laparoscopic surgery complications in unselected population of operators. ISGE Meeting. 1997."},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Querteu D, Chapron C, Chevallier L et al. Complications of gynaecological laparoscopic surgery. A French multicentre collaborative study. Gynaecol Endosc. 1993;328:1335.","DOI":"10.1056\/NEJM199305063281817"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Richardson RE, Sutton CJG. Complications of first entry: a prospective laparoscopy audit. Gynaecol Endosc. 2001;8:327-34.","DOI":"10.1046\/j.1365-2508.1999.00299.x"}],"container-title":["Facts, Views and Vision in ObGyn"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T05:55:47Z","timestamp":1739512547000},"score":1,"resource":{"primary":{"URL":"https:\/\/fvvo.eu\/articles\/doi\/FVVO.15.2.061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,6]]},"published-print":{"date-parts":[[2023,6]]}},"URL":"https:\/\/doi.org\/10.52054\/fvvo.15.2.061","relation":{},"ISSN":["2684-4230","2032-0418"],"issn-type":[{"type":"electronic","value":"2684-4230"},{"type":"print","value":"2032-0418"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}