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Related Experiment Videos

Randomized trial comparing a radially expandable needle system with cutting trocars.

J R Feste1, B Bojahr, D J Turner

  • 1Texas Women's Hospital, Houston 77054-1989, USA. JoeFeste@classic.msn.com

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|April 20, 2000
PubMed
Summary

Sharp trocars increase risks in laparoscopic surgery. A new blunt dilator system significantly reduced patient pain, complications, and procedure time, enhancing safety and comfort.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology
  • Patient Safety

Background:

  • Sharp trocar insertion in laparoscopic surgery is associated with risks of vascular/visceral injury and incisional hernia.
  • Conventional trocars pose a risk of instrument-related adverse events, including abdominal wall injuries and bowel perforations.

Purpose of the Study:

  • To compare the safety and efficacy of sharp trocars versus a novel radially expanding needle system with a blunt dilator in laparoscopic procedures.
  • To evaluate patient-reported pain, complication rates, and procedure duration between the two systems.

Main Methods:

  • A randomized trial involving 87 patients comparing sharp trocars with a radially expanding needle system and blunt dilator.
  • Data collection included adverse events, patient pain assessment, and procedure time for both treatment groups.

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Main Results:

  • The blunt dilator/cannula system group experienced statistically improved patient pain assessment and a lower overall complication rate.
  • Conventional trocars resulted in six instrument-related adverse events (4/42), including abdominal wall injuries and small bowel perforation.
  • The blunt dilator group had only one unrelated adverse event (1/45), a Veress needle injury to abdominal vasculature.

Conclusions:

  • The radially expanding access system with a blunt dilator offers statistically improved patient postoperative comfort and enhanced patient safety compared to sharp trocars.
  • This novel system represents a safer alternative for laparoscopic access, minimizing risks associated with sharp instrument insertion.