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. 2019 Apr-Jun;23(2):e2019.00002.
doi: 10.4293/JSLS.2019.00002.

Laparoscopic Insertion of Various Shaped Trocars in a Porcine Model

Danilo Galante Moreno  1 , Cesar Augusto Martins Pereira  1 , Ricardo Kyoiti Sant Anna  2 , Rafael Ulysses de Azevedo  2 , Luiz Felipe Savio  2 , Ricardo Jordão Duarte  1 , Miguel Srougi  1 , Carlo Camargo Passerotti  1
Affiliations

Laparoscopic Insertion of Various Shaped Trocars in a Porcine Model

Danilo Galante Moreno et al. JSLS. 2019 Apr-Jun.

Abstract

Background and objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Animal model; Laparoscopy; Safety; Trocar.

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Conflict of interest statement

Conflicts of Interest: All authors declare no conflict of interest regarding the publication of this article.

Figures

Figure 1.
Figure 1.
Experiment setup. The metal frame supporting the abdominal wall is in place with a camera positioned on a tripod. Punctures were performed every 1 cm with a hand sensor between the trocar and the surgeon's hand.
Figure 2.
Figure 2.
Hand sensor for force detection.
Figure 3.
Figure 3.
Two force peaks required for fascia (aponeurosis) (F1) and peritoneum (F2) perforation as detected by the hand sensor.
Figure 4.
Figure 4.
Time (Tbl) and distance (Dbl) the cutting surface of the bladed trocars was exposed inside the abdominal cavity.
See this image and copyright information in PMC

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