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Optical access trocar injuries in urological laparoscopic surgery
Mathew A Thomas1, Koon H Rha, Albert M Ong
1Department of Urology, James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, 600 North Wolfe Street, Marburg 407, Baltimore, MD 21287-2411, USA.
The Journal of Urology
|June 11, 2003
Summary
Optical access trocars are a safe laparoscopic surgery technique. This study found a low complication rate (0.31%) for optical trocar placement during urological procedures.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Technology
Background:
- Laparoscopic surgery carries risks of trocar and Veress needle injuries.
- Optical trocars offer direct visualization for safer access.
- Limited data exist on optical trocar safety in urological laparoscopy.
Purpose of the Study:
- To assess complications associated with optical access trocars.
- To evaluate the safety of optical trocars in transperitoneal urological laparoscopic procedures.
Main Methods:
- Retrospective review of 1,283 urological laparoscopic procedures using optical access trocars (1995-2001).
- Procedures included nephrectomies, pyeloplasty, and others.
- Analysis focused on intra-abdominal complications from optical trocar insertion.
Main Results:
- Four injuries (0.31%) occurred with optical trocars.
- Injuries included bowel, mesenteric, and epigastric vessel damage.
- Most injuries were recognized and repaired immediately; one required postoperative repair.
Conclusions:
- Optical access trocars are a safe and rapid method for initial trocar placement.
- This large series confirms a low incidence of trocar-related complications with optical trocars.