Comparative analysis of 5-mm trocars: dilating tip versus non-shielded bladed

Area of Science:

• Minimally Invasive Gynecologic Surgery
• Surgical Instrumentation

Background:

• Laparoscopic surgery utilizes trocars for instrument insertion.
• Different trocar designs, such as dilating-tip trocars (DTTs) and non-shielded-bladed trocars (NSBTs), may influence surgical outcomes.

Purpose of the Study:

• To compare the efficacy and safety of 5-mm DTTs versus 5-mm NSBTs for lateral laparoscopic access in gynecologic surgery.
• To evaluate differences in placement, displacement, bleeding, pain, and cosmetic results between DTTs and NSBTs.

Main Methods:

• A randomized, single-blinded, controlled trial was conducted with 94 women undergoing laparoscopic surgery for benign gynecologic conditions.
• Each patient received both a DTT and an NSBT at contralateral lateral entry sites.
• Outcomes were assessed by surgeons, nurses, and patients using a visual analog scale at various intraoperative and postoperative time points.

Main Results:

• NSBTs demonstrated statistically significant advantages in ease of placement and lower displacement rates compared to DTTs.
• No statistically significant differences were observed between the two trocar types regarding bleeding, hematoma formation, pain, or cosmetic results.
• Both nurses and patients were blinded to the trocar type used on each side.

Conclusions:

• NSBTs offer superior ease of placement and reduced displacement compared to DTTs for lateral laparoscopic access in gynecologic procedures.
• Despite design differences, DTTs and NSBTs exhibit comparable safety profiles concerning bleeding, pain, and aesthetics.
• The choice between DTTs and NSBTs should be individualized based on surgical goals and patient-specific factors.