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Does the Difference in Fascial Closure Technique Affect Postoperative Pain?

Anna Lyapis1, Amanda Ulrich2, Rachel LaMonica3

  • 1Obstetrics & Gynecology, Fremont, California.

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|August 1, 2017
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Summary

This study found that using a fascia closure device (FCD) for robotic surgery incisions resulted in higher postoperative pain on day 1 compared to traditional fascial closure (TFC). No significant difference in closure time was observed between the two methods.

Keywords:
Fascial closure devicePostoperative painRobotic surgery

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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Techniques
  • Pain Management

Background:

  • Robotic surgery is increasingly used for benign gynecological indications.
  • Effective and minimally painful port site closure is crucial for patient recovery.
  • Traditional fascial closure (TFC) methods may cause variable incisional pain.

Purpose of the Study:

  • To compare postoperative incisional pain at 1 and 14 days after robotic surgery.
  • To evaluate pain associated with a fascia closure device (FCD) versus TFC for 12-mm upper quadrant ports.
  • To compare the time required for fascial incision closure using FCD and TFC.

Main Methods:

  • A randomized controlled trial (Canadian Task Force classification I) was conducted.
  • 65 women undergoing robotic surgery for benign gynecological conditions were randomized to FCD or TFC.
  • Pain scores (10-point analog scale) were recorded on postoperative days 1 and 14. Closure time was also measured.

Main Results:

  • On postoperative day 1, mean pain scores were significantly higher with FCD (3.43 ± 2.48) than TFC (2.06 ± 2.03) (p=0.028).
  • On postoperative day 14, pain scores were 1.97 ± 2.48 for FCD and 0.83 ± 1.42 for TFC (p=0.102), with no significant difference.
  • Mean closure times were 106.5 ± 102.28 seconds for FCD and 141.97 ± 102.85 seconds for TFC (p=0.138), showing no significant difference.

Conclusions:

  • The fascia closure device (FCD) leads to increased incisional pain on postoperative day 1 compared to traditional fascial closure (TFC).
  • There was no significant difference in pain scores on postoperative day 14 between the FCD and TFC groups.
  • The fascia closure device did not significantly reduce the time required for fascial closure.