Open Laparoscopy.mp4

This video describes a safe, simple and easy technique of performing an open laparoscopy. Open laparoscopy was originally developed by Dr H. Hasson and has been gaining increasing popularity. Yet many surgeons continue to use Veress needle which is inserted blindly and thus has an inherent, all be it small risk of injury even in experienced hands. The risk of injury due to Veress needle insertion is higher in patients with a history of abdominal surgery and/or adhesions. Open laparoscopy becomes even more important to use with increasing number of laparoscopies being performed by trainee or less experienced surgeons. The steps in this video show a small semicircular skin incision just below the umbilicus, dissection of the subcutaneous fat for a clear view of the deep fascia. The aponeurotic umbilical stalk is then grasped with Littlewoods forceps and delivered into the wound. The deep fascia is then opened and the peritoneum entered under direct vision using a blunt instrument. A finger is subsequently inserted to check for possible adhesions, followed by the introduction of a cannula with blunt obturator. The abdominal cavity is then insufflated, and the required telescope is passed through the cannula.

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