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The driving force in trocar insertion: a comparison between disposable and reusable trocars
C J Kelty1, P A Super, C J Stoddard
1Department of Surgery, K Floor, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK.
Surgical Endoscopy
|January 11, 2000
Summary
Disposable trocars require less insertion force than reusable ones, with used reusable trocars demanding the most force. This finding highlights risks associated with reusable instruments in laparoscopic surgery.
Area of Science:
- Surgical instrumentation
- Minimally invasive surgery
- Laparoscopic techniques
Background:
- Trocar insertion is a high-risk step in laparoscopic surgery.
- Complications include major vascular and bowel injuries.
- Insertion ease may influence complication rates.
Purpose of the Study:
- To compare the insertion force of disposable and reusable trocars.
- To evaluate the impact of previous use on reusable trocar insertion force.
Main Methods:
- Compared disposable and reusable trocars (identical point cross-section and size).
- Used an abdominal wall model with animal hide.
- Measured insertion force using a hand-held pressure transducer (PSI).
Main Results:
- Disposable trocars required the least force (mean 2.76 PSI).
- New reusable trocars required moderate force (mean 3.42 PSI).
- Used reusable trocars required the most force (mean 4.80 PSI).
Conclusions:
- Previous use significantly increases the insertion force of reusable trocars.
- Higher insertion force with some trocars may increase patient risk of injury.
- Reusable instruments present a disadvantage due to increased insertion effort after use.