Trocars: new data on safety and selection

In our November 1998 issue, we published a Guidance Article on the issues surrounding trocar selection and use. In the current article, we update that information with the results of a survey conducted in conjunction with the monthly newsletter OR Manager. The survey characterizes trocar practices in more than 60 U.S. healthcare facilities, focusing on the following issues: Do surgeons use shielded or nonshielded trocars for primary insertions? And do surgeons use disposable or reusable models? The survey indicated that most surgeons in the responding healthcare facilities use nonshielded trocars during at least half of their laparoscopic procedures. It also indicated that most surgeons use disposable models. These findings suggest that many surgeons support the views presented in our 1998 Guidance Article. In the supplementary article "Eye on Medical Errors," we discuss the likely prevalence of trocar-related injuries. This discussion includes recent--and rare--data from insurance claims for trocar injuries.