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Surgical Endoscopy

Published in:

01-12-2008

Laparoscopic entry techniques: clinical guideline, national survey, and medicolegal ramifications

Authors: Rajesh Varma, Janesh K. Gupta

Published in: Surgical Endoscopy | Issue 12/2008

Abstract

Background

This study aimed to establish criteria for safe laparoscopic entry through a systematic literature search and evidence-based medicine appraisal, to determine surgeon preferences for laparoscopic entry in the United Kingdom, and to appraise the medicolegal ramifications of complications arising from laparoscopic entry.

Methods

A systematic literature search of MEDLINE and EMBASE (1996–2007) was performed as well as a national surgeon survey by questionnaire (May–December 2006).

Results

Laparoscopic entry criteria involving 10 steps were established based on the systematic literature search and evidence-based critical appraisal. The national survey had 226 respondents, with the majority aware of the Middlesbrough consensus or Royal College of Obstetricians and Gynaecologists [RCOG]-sourced guidance. There was considerable variation in preferred laparoscopic entry techniques. Currently, there is clear judicial guidance on the medicolegal stance toward laparoscopic entry-related complications.

Conclusions

Despite widespread awareness of laparoscopic entry guidelines, there remains considerable variation in the techniques adopted in clinical practice. Unless practice concurs with recommended guidance, women undergoing laparoscopy will be exposed to increased unnecessary operative risk. Laparoscopic entry-related injury in an uncomplicated woman is considered negligent practice according to UK legal case law.

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Title: Laparoscopic entry techniques: clinical guideline, national survey, and medicolegal ramifications
Authors: Rajesh Varma
Janesh K. Gupta
Publication date: 01-12-2008
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 12/2008
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-008-9871-6

At a glance: The STEP trials

Springer Medicine

Laparoscopic entry techniques: clinical guideline, national survey, and medicolegal ramifications

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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