The driving force in trocar insertion: a comparison between disposable and reusable trocars.
Source:Surgical Endoscopy 2000
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Author:Tao
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Published time: 2018-05-06
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BACKGROUND:
Insertion of the first trocar during the "closed" technique of
creating a pneumoperitoneum remains one of the most hazardous maneuvres in
laparoscopic surgery, with complications such as major vascular and bowel
injuries. The ease with which trocars are inserted through the abdominal wall
may have some bearing on these complications. METHODS: A range of both disposable and reusable trocars, which
were identical in point cross section and size, were compared in an abdominal
wall model reconstructed with animal hide, using a hand-held pressure
transducer. Multiple insertions were performed, and the results were expressed
in pounds per square inch (PSI). RESULTS:
The disposable trocar tested required the least effort to insert (mean
pressure, 2.76 PSI), followed by the new reusable (mean pressure, 3.42 PSI),
with the used reusable trocar requiring
the greatest force for insertion (mean pressure, 4.80 PSI). CONCLUSIONS: The effect of previous use
on ease of insertion demonstrates an obvious disadvantage of reusable
instruments. The excessive force required to insert some trocars may place the
patient at greater risk of trocar injury
