Open laparoscopy as a method of access in laparoscopic surgery

Objective To describe the technique of open laparoscopy and compare the rates of its complications to those of closed laparoscopy. Design Medline search, review of the literature and the author's experience. Results For open laparoscopy, the rate of umbilical infection in 15 622 cases was 0.4%, that of bowel injury in 20 335 cases was 0.1%, based on prospective, retrospective studies and a mail survey. Prospective and retrospective studies dealing with closed laparoscopy reported the following complication rates: umbilical infection: 1% of 4377 cases; vascular injury: 0.2% of 94 863 cases: visceral injury: 0.2% of 91 272 cases. The operating time for open and closed laparoscopy were substantially similar. Conclusion Open laparoscopy is advocated as the preferred method of access for laparoscopic surgery.