Open laparoscopic access for primary trocar using modified Hasson's technique.

OBJECTIVE: To describe the safety and efficacy of open laparoscopic access for the primary trocar using modified Hasson's technique for laparoscopic surgery in children.

METHODS: All 100 laparoscopic procedures performed at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between January 1999 and April 2001 using modified Hasson's technique were prospectively evaluated. They were aged from 3 months to 12 years.

RESULTS: One hundred children who had open laparoscopic access during the study period had diagnosis of acute appendicitis (n=57), impalpable undescended testes (n=29), gallstones (n=5), varicocele (n=3) and others (n=6). Three children had minor operative complications (2 cases of pre-peritoneal placement of trocar, which were recognized immediately and the other had omental bleeding). Two children had post-operative complications related to primary access (one port infection and other port site hematoma). Access to the abdominal cavity was generally secured in 3-12 minutes (average 4+/-2). Clinic follow-up ranged from 3-14 months.

CONCLUSION: Open laparoscopic access using modified Hasson's technique was associated with no major or life-threatening complications. Minor operative (3%) and post-operative (2%) complications occurred in the first 100 cases. Modified Hasson's technique for the primary trocar for accessing the abdominal cavity is a safe and effective method, and is recommended for all laparoscopic procedures in children.