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Grasper trauma during laparoscopic cholecystectomy
D D Marucci1, A J Shakeshaft, J A Cartmill
1Department of Surgery, University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia.
The Australian and New Zealand Journal of Surgery
|August 17, 2000
Summary
Laparoscopic graspers cause identifiable tissue trauma during gallbladder surgery. This study establishes a reliable human model to histologically assess this grasper-induced injury.
Area of Science:
- Surgical pathology
- Minimally invasive surgery
- Histology
Background:
- Laparoscopic cholecystectomy involves tissue manipulation with surgical graspers.
- Potential for iatrogenic tissue trauma from laparoscopic graspers is a concern.
- A validated model is needed to assess grasper-tissue interactions.
Purpose of the Study:
- To characterize the histopathological effects of laparoscopic grasper use.
- To establish a reproducible human model for studying grasper-induced tissue trauma.
- To test the hypothesis that graspers cause distinct histological injury.
Main Methods:
- Prospective, blinded examination of gallbladder specimens from 19 patients.
- Excision of grasped (sample) and non-grasped (control) gallbladder tissue.
- Histological assessment for markers of crushed tissue injury by a blinded pathologist.
Main Results:
- Pathologist correctly identified the grasped specimen in 13 of 19 cases (P = 0.003).
- Focal thinning of the gallbladder wall was significantly more prevalent in grasped specimens (P = 0.0002).
- Epithelial loss was significantly higher in grasped specimens (P < 0.0001).
Conclusions:
- Laparoscopic graspers induce histologically assessable tissue trauma.
- The study successfully developed a reproducible human model for grasper-tissue interaction.
- Findings confirm that graspers cause distinct tissue injury during laparoscopic procedures.