Cochrane · systematic review · CD006583
Laparoscopic entry techniques
Ahmad, G, Baker, J, Finnerty, J, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
30
current version
GRADE rated
15
No studies
11
Included studies
NR
No studies 11 · 36.7%Ungraded 4 · 13.3%Very low 14 · 46.7%Low 0 · 0%Moderate 1 · 3.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Show all 3 versionsOpen‐entry vs closed‐entry technique for patients undergoing laparoscopy
Population: patients undergoing laparoscopy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Open‐entry vs closed‐entry technique | no estimate extracted | 2 studies · 715 participants | Ungraded |
Vascular injury (major vessels and abdominal wall vessels) Open‐entry vs closed‐entry technique | Peto OR 0.14 [0, 6.82] | 4 studies · 915 participants | Very low Downgraded: risk of bias, imprecision |
Visceral injury (bladder or bowel) Open‐entry vs closed‐entry technique | Peto OR 0.61 [0.06, 6.08] | 4 studies · 915 participants | Very low Downgraded: risk of bias, imprecision |
Gas embolism Open‐entry vs closed‐entry technique | no estimate extracted | NR | No studies |
Solid organ injury Open‐entry vs closed‐entry technique | no estimate extracted | NR | No studies |
Failed entry Open‐entry vs closed‐entry technique | Peto OR 0.45 [0.14, 1.42] | 3 studies · 865 participants | Very low Downgraded: risk of bias |
Direct trocar entry vs Veress needle entry for patients undergoing laparoscopy
Population: patients undergoing laparoscopic surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Direct trocar entry vs Veress needle entry | no estimate extracted | 4 studies · 1438 participants | Ungraded |
Vascular injury (major vessels and abdominal wall vessels) Direct trocar entry vs Veress needle entry | Peto OR 0.59 [0.18, 1.96] | 6 studies · 1603 participants | Very low Downgraded: risk of bias, imprecision |
Visceral injury (bladder or bowel) Direct trocar entry vs Veress needle entry | Peto OR 2.02 [0.21, 19.42] | 5 studies · 1519 participants | Very low Downgraded: risk of bias, imprecision |
Gas embolism Direct trocar entry vs Veress needle entry | no estimate extracted | 2 studies · 810 participants | Ungraded |
Solid organ injury Direct trocar entry vs Veress needle entry | Peto OR 0.58 [0.06, 5.65] | 3 studies · 1079 participants | Very low Downgraded: risk of bias, imprecision |
Failed entry Direct trocar entry vs Veress needle entry | Peto OR 0.24 [0.17, 0.34] | 8 studies · 3185 participants | Moderate Downgraded: risk of bias, imprecision |
Direct vision entry vs Veress needle entry for patients undergoing laparoscopy
Population: patients undergoing laparoscopy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Direct vision entry vs Veress needle entry | no estimate extracted | NR | No studies |
Vascular injury (major vessels and abdominal wall vessels) Direct vision entry vs Veress needle entry | Peto OR 0.39 [0.05, 2.85] | 1 study · 186 participants | Very low Downgraded: risk of bias, imprecision |
Visceral injury (bladder or bowel) Direct vision entry vs Veress needle entry | Peto OR 0.15 [0.01, 2.34] | 2 studies · 380 participants | Very low Downgraded: risk of bias, imprecision |
Gas embolism Direct vision entry vs Veress needle entry | no estimate extracted | NR | No studies |
Solid organ injury Direct vision entry vs Veress needle entry | no estimate extracted | NR | No studies |
Failed entry Direct vision entry vs Veress needle entry | no estimate extracted | NR | No studies |
Direct vision entry vs open‐entry technique for patients undergoing laparoscopy
Population: patients undergoing laparoscopy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Direct vision entry vs open‐entry technique | no estimate extracted | NR | No studies |
Vascular injury (major vessels and abdominal wall vessels) Direct vision entry vs open‐entry technique | no estimate extracted | 2 studies · 392 participants | Ungraded |
Visceral injury (bladder or bowel) Direct vision entry vs open‐entry technique | Peto OR 0.13 [0, 6.5] | 2 studies · 392 participants | Very low Downgraded: risk of bias, imprecision |
Gas embolism Direct vision entry vs open‐entry technique | no estimate extracted | NR | No studies |
Solid organ injury Direct vision entry vs open‐entry technique | Peto OR 6.16 [0.12, 316.67] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Failed entry Direct vision entry vs open‐entry technique | Peto OR 0.4 [0.04, 4.09] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Radially expanding (STEP) trocars for primary port entry vs standard (non‐expanding) trocars for patients undergoing laparoscopy
Population: patients undergoing laparoscopy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Radially expanding (STEP) trocars for primary port entry vs standard (non‐expanding) trocars | no estimate extracted | NR | No studies |
Vascular injury (major vessels and abdominal wall vessels) Radially expanding (STEP) trocars for primary port entry vs standard (non‐expanding) trocars | Peto OR 0.24 [0.05, 1.21] | 2 studies · 331 participants | Very low Downgraded: risk of bias, imprecision |
Visceral injury (bladder or bowel) Radially expanding (STEP) trocars for primary port entry vs standard (non‐expanding) trocars | Peto OR 0.13 [0, 6.37] | 2 studies · 331 participants | Very low Downgraded: risk of bias, imprecision |
Gas embolism Radially expanding (STEP) trocars for primary port entry vs standard (non‐expanding) trocars | no estimate extracted | NR | No studies |
Solid organ injury Radially expanding (STEP) trocars for primary port entry vs standard (non‐expanding) trocars | Peto OR 1.05 [0.07, 16.91] | 1 study · 244 participants | Very low Downgraded: risk of bias, imprecision |
Failed entry Radially expanding (STEP) trocars for primary port entry vs standard (non‐expanding) trocars | no estimate extracted | NR | No studies |