A Simple Technique for Laparoscopic Drain Placement

Abstract

Background:

Intra-abdominal drain placement is necessary for some operations and is a huge challenge in obese individuals undergoing laparoscopic surgery. In this context, no specific techniques of drain placement are described.

Aim:

To demonstrate a simple technique of laparoscopic drain placement that is applicable to a range of surgical settings.

Technique/Video:

The technique involves passage of a grasper down one port into the internal aperture of another appropriately sited port. The dissector is advanced until visible through the receptor port shaft externally. The receptor port is then withdrawn, and the tip of a suitable drain is grasped and drawn through the port tract into the abdominal cavity. The drain is then placed where required under vision. Pneumoperitoneum is maintained by clamping and expeditiously introducing the drain into the abdominal cavity. External fixation and connection to a suction device is as per convention.

Result:

The technique has been utilized in various contexts: in heminephrectomies, difficult cholecystectomies with bleeding and risk of bile leakage, and for hemisplenectomy. The heaviest patient weighed just over 100 kg. No complications were experienced with drain placement or removal.

Conclusion:

This technique of drain placement is atraumatic, makes use of an existing port site, and is expeditiously performed. Critically, pneumoperitoneum is preserved, allowing for the laparoscopic procedure to be completed. It is ideally suited to the obese patient where abdominal drain placement from the outside may otherwise be a challenge.

No competing financial interests exist.

Runtime of video: 1 min 30 secs