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A new Dual-hemostat technique to facilitate the closure of small laparoscopic trocar incisions
S C Spalding1, T A Ponsky, E Oristian
1Department of Surgery, Holy Cross Hospital, 1500 Forest Glen Road, Silver Springs, MD 20910, USA.
Background:
The introduction of any surgical procedure brings with it new technical challenges. The use of laparoscopy offers patients a reduction in pain and better cosmesis. However, over time, new technical challenges associated with laparoscopic surgery are becoming more evident. In particular, the closure of the small trocar site fascial incisions is often awkward and time consuming. The aim of this article is to introduce a closing procedure that facilitates the safe approximation of the abdominal fascia in these wounds.
Method:
One hemostat is used to visualize the fascia of one side of the wound and separate the fascia from the underlying abdominal viscera. Another hemostat retracts the opposite side of the wound. The suture needle is passed through the fascia and between the open tips of the hemostat. The tips of the second hemostat grasp the driven needle and carry it out of the wound.
Conclusion:
The use of two hemostats to close these wounds not only facilitates the closure but is also probably safer than the standard technique.
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