Comparison of five different abdominal access trocar systems: analysis of insertion force, removal force, and defect...

Trocar designs have evolved in response to concerns about complication rates and surgical ergonomics. Functional properties of trocar systems that can be objectively measured include insertion force, removal force and the size of the tissue defect. This study will evaluate these properties in 5 common trocar designs. A porcine model was used to evaluate five different trocar systems for insertion force, removal force, and functional and measured tissue defect. Insertion force was lowest for cutting trocars and highest for radially dilating trocars. Removal force was similar for all trocars. Functional and measured tissue defect size was smallest for the hybrid type and radially dilating trocars. An ideal trocar system incorporates a low insertion force, secure retention, and a minimal tissue defect. Of the systems we tested, the hybrid type trocar has similar wound characteristics to the radially dilating trocar with the benefit of reduced insertion force. Further study is required to determine if these properties translate to an actual improvement in patient outcome.