What do systematic reviews say?

Direct trocar entry vs Veress needle entry

It is very uncertain whether direct trocar entry changes vascular injury (major vessels and abdominal wall vessels) compared with veress needle entry (very low certainty).

• Laparoscopic entry techniques 2019 · Cochrane Headline outcomes only
  Peto OR 0.59 [0.18, 1.96]
  6 studies · 1603 participants
  Very low

Direct trocar entry vs Veress needle entry

It is very uncertain whether direct trocar entry changes visceral injury (bladder or bowel) compared with veress needle entry (very low certainty).

• Laparoscopic entry techniques 2019 · Cochrane Headline outcomes only
  Peto OR 2.02 [0.21, 19.42]
  5 studies · 1519 participants
  Very low

Specific technique vs standard techniques

Specific technique showed no clear difference in incidence of STP at 24 hours post‐operatively compared with standard technique (low certainty).

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  OR 0.87 [0.41, 1.82]
  1 study · 118 participants
  Low

Intraperitoneal drain vs no intraperitoneal drain

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 320 participants
  Very low

Intraperitoneal drain vs no intraperitoneal drain

The review found no eligible studies for this question.

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intraperitoneal drain vs no intraperitoneal drain

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 253 participants
  Low

Subdiaphragmatic intraperitoneal local anaesthetic vs control

Subdiaphragmatic intraperitoneal local anaesthetic showed no clear difference in incidence of STP at 24 hours post‐operatively compared with control (moderate certainty).

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  OR 0.72 [0.42, 1.23]
  4 studies · 336 participants
  Moderate

Subdiaphragmatic intraperitoneal local anaesthetic vs control

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 50 participants
  Low

Subdiaphragmatic intraperitoneal local anaesthetic vs control

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 165 participants
  GRADE not reported

Subdiaphragmatic intraperitoneal local anaesthetic vs control

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 129 participants
  Low

Local anaesthetic to peritoneal cavity (not subdiaphragmatic) vs control

Local anaesthetic to peritoneal cavity (not subdiaphragmatic) may leads to lower incidence of STP within 4‐8 hours post‐operatively compared with control (low certainty).

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  OR 0.23 [0.06, 0.93]
  2 studies · 157 participants
  Low

Local anaesthetic to peritoneal cavity (not subdiaphragmatic) vs control

The review found no eligible studies for this question.

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Local anaesthetic to peritoneal cavity (not subdiaphragmatic) vs control

The review found no eligible studies for this question.

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Specific technique vs standard techniques

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 670 participants
  Low

Local anaesthetic to peritoneal cavity (not subdiaphragmatic) vs control

The review found no eligible studies for this question.

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Warmed, or warmed and humidified CO2 vs unwarmed and unhumidified CO2

Warmed, or warmed and humidified CO2 showed no clear difference in incidence of STP within 24‐48 hours post‐operatively compared with unwarmed and unhumidified CO2 (low certainty).

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  OR 0.81 [0.45, 1.49]
  2 studies · 194 participants
  Low

Warmed, or warmed and humidified CO2 vs unwarmed and unhumidified CO2

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 157 participants
  Moderate

Warmed, or warmed and humidified CO2 vs unwarmed and unhumidified CO2

The review found no eligible studies for this question.

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Warmed, or warmed and humidified CO2 vs unwarmed and unhumidified CO2

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 95 participants
  Low

Gasless laparoscopy vs CO2 insufflation

The review found no eligible studies for this question.

• Interventions to reduce shoulder pain following gynaecological laparoscopic procedures 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found