Decision-Making Process and Reasoning of Laparoscopic Entry: A Questionnaire-Based Analysis of Surgical Practice: A Cross-Sectional Study

Abstract

Objective: Several techniques for initial abdominal entry in laparoscopy have been introduced in the literature. Various guidelines and recommendations are available on this subject; however, compliance with these findings is controversial. The purpose of this study is to evaluate the rationale and \rthe process of decision-making for the first entry technique in laparoscopy.\rMethods: A close-ended survey question was formed. The survey was sent to general surgeons by e-mail with the survey's web address included and \radministered face-to-face in the National Congress of General Surgery. Descriptive statistical methods (mean, standard deviation, median, frequency, ratio, \rminimum, and maximum) were used to evaluate the study data. Relevance was calculated as P< .05 in the 95% CI. \rResults: A total of 263 surveys were evaluated. The most common preferred method was the \"Veress needle technique\" during the residency of the participants. However, fewer surgeons preferred this method (P< .001), the open approach/Hasson trocar (P= .004) and direct trocar insertion (P= .003) were \rmore prevalent after residency. The most common rationale for choosing the laparoscopic entry technique was \"learned laparoscopic entry technique \rduring residency\" (38.0%) and \"ease of applicability\" (27.0%). Reasons for changing the laparoscopic entry technique during surgical practice are \"easy \rapplicability\" in 37% and \"advice of competent people on general surgery\" in 24.4% of participants.\rConclusion: This study revealed that the decision-making for initial abdominal entry for laparoscopy was influenced mainly by the surgeon's experience during residency, the mentors' effect, and ease of applicability of a technique.