To Avoid Trocar Injuries in Multiple Previous Surgeries-Jain Point

The use of laparoscopic access in patients with multiple previous surgeries presents challenges due to altered anatomy and the risk of vascular and bowel injuries. The conventional umbilical entry, though widely used, poses risks due to adhesions. In response, alternative entry points like Palmer’s and Lee Huang points were explored, each with its limitations. The Jain point, located para-umbilically and laterally, emerges as a safe and versatile entry port, devoid of contraindications observed in other points. Positioned at L4 level, it provides a clear area for entry, avoiding adhesions and ensuring safety in various abdominal quadrants, even with previous scars. The Jain point’s success is highlighted in a 12-year study involving over 9500 patients, demonstrating its feasibility and safety in gynaecological, general, and multidisciplinary surgeries. The surface marking at the anterior superior iliac spine ensures accurate entry. The technique emphasizes using a veress needle and 5 mm trocar, with ergonomic benefits sustained throughout the surgery. Unlike Palmer’s point, Jain point remains relevant, serving as the main ergonomic working port post-entry. The Jain point distinguishes itself from Palmer’s point in terms of contraindications, anatomical landmarks, and continuous functionality. In conclusion, the Jain point stands out as a safe, adaptable, and ergonomic alternative for laparoscopic entry, offering a solution to the challenges posed by multiple previous surgeries.