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Port-site closure: a new problem, an old device.
Nicola Di Lorenzo1, Giorgio Coscarella, Francesca Lirosi
1University of Rome, Tor Vergata Department of Surgery, Italy.
Summary
The Deschamps needle effectively prevents trocar-site hernias and wound dehiscence in laparoscopic surgery. This cost-effective instrument offers a reliable solution for wound closure, improving patient outcomes.
Area of Science:
- Surgical techniques
- Minimally invasive surgery
- Hernia prevention
Background:
- Trocar-site incisional hernias occur in 1-6% of patients after laparoscopic procedures.
- Standard suturing techniques are difficult for closing trocar sites, leading to hernias.
- The Deschamps ligature needle offers a novel approach to wound closure.
Purpose of the Study:
- To evaluate the efficacy of the Deschamps needle in preventing trocar-site incisional hernias.
- To assess the Deschamps needle's utility in laparoscopic wound closure.
- To determine the cost-effectiveness of the Deschamps needle.
Main Methods:
- Utilized the Deschamps needle for closing 5-mm and 10-mm trocar sites in 1400 laparoscopic procedures since 1992.
- Employed direct visualization through the scope and tactile feedback for full-thickness fascial and peritoneal closure.
- Closed the final trocar site without the scope, using the same technique.
Main Results:
- No instances of wound dehiscence or incisional hernias were observed at the closed trocar sites.
- The Deschamps needle facilitated closure of fascia and peritoneum, preventing pneumoperitoneum loss.
- The instrument proved effective for both 5-mm and 10-mm port sites.
Conclusions:
- The Deschamps needle is a highly effective instrument for preventing incisional hernias and wound dehiscence after laparoscopic surgery.
- The needle is a cost-effective solution, with a low per-use cost, especially considering its long-term availability.
- Its rigid, non-cutting design allows for safe passage through fascial and peritoneal layers.