Laparoscopic Insertion of Various Shaped Trocars in a Porcine Model

The number of laparoscopic procedures increases annually with an estimated 3% of complications, one third of them linked to Verres' needle or trocar insertion. The safety and efficacy of ports insertion during laparoscopic surgery may be related the technique but also to trocar design. This stu...

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Bibliographic Details
Published in:	Journal of the Society of Laparoendoscopic Surgeons Vol. 23; no. 2; p. e2019.00002
Main Authors:	Moreno, Danilo Galante, Pereira, Cesar Augusto Martins, Sant Anna, Ricardo Kyoiti, de Azevedo, Rafael Ulysses, Savio, Luiz Felipe, Duarte, Ricardo Jordão, Srougi, Miguel, Passerotti, Carlo Camargo
Format:	Journal Article
Language:	English
Published:	United States Society of Laparoendoscopic Surgeons 01-04-2019
Subjects:	Abdominal Wall - surgery Animals Equipment Design Laparoscopy - instrumentation Laparoscopy - methods Models, Animal Scientific Paper Swine Animal model Trocar Laparoscopy Safety
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Summary:	The number of laparoscopic procedures increases annually with an estimated 3% of complications, one third of them linked to Verres' needle or trocar insertion. The safety and efficacy of ports insertion during laparoscopic surgery may be related the technique but also to trocar design. This study aims to compare physical parameters of abdominal wall penetration for 5 different trocars. Eleven pigs were studied. Five different commercially available trocars were randomically inserted at the midline. Real-time video recording of the insertions was achieved to measure the excursion of the abdominal wall and the time and distance the cutting surface of the bladed trocars was exposed inside the abdominal cavity. An especially designed hand sensor was developed and placed between the trocar and the hand of the surgeon to record force required for abdominal wall perforation. Greater deformations and forces occurred in nonbladed as compared to bladed trocars, and in conical trocars as compared to pyramidal pointed ones, except for peritoneum perforation. Greater distance and time of blade exposure occurred in pyramidal laminae as compared to conical. The bladed trocars have lower forces and deformations in their introduction, and should be those that cause less injury and are more suitable for first entry. Conical and pyramidal trocars with the same blade size showed similar force, deformation, time, and distance of exposed blade.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Informed consent: Dr. Passerotti declares that written informed consent was obtained from the patient for publication of this study/report and any accompanying images. Conflicts of Interest: All authors declare no conflict of interest regarding the publication of this article. Disclosures: The authors have no disclosures.
ISSN:	1086-8089 1938-3797 1938-3797
DOI:	10.4293/jsls.2019.00002