Laparoscopic Insertion of Various Shaped Trocars in a Porcine Model

Area of Science:

• Minimally Invasive Surgery
• Surgical Device Engineering
• Gastrointestinal Surgery

Background:

• Laparoscopic procedures are increasing, with complications arising from Verres' needle and trocar insertion.
• Trocar design significantly impacts the safety and efficacy of port insertion during laparoscopic surgery.

Purpose of the Study:

• To compare the physical parameters of abdominal wall penetration for five distinct trocar designs.
• To evaluate the forces, deformations, and exposure times associated with different trocar insertion techniques.

Main Methods:

• Eleven pigs underwent random midline trocar insertions using five commercial trocars.
• Real-time video recorded abdominal wall excursion, while a custom hand sensor measured perforation forces.
• Blade exposure time and distance were quantified for bladed trocar types.

Main Results:

• Bladed trocars exhibited lower forces and deformations compared to non-bladed ones.
• Conical trocars showed greater deformation and force than pyramidal trocars, except during peritoneum perforation.
• Pyramidal trocars had longer blade exposure times and distances than conical trocars.

Conclusions:

• Bladed trocars are recommended for initial entry due to lower forces and deformations, potentially reducing injury.
• Conical and pyramidal trocars of equivalent blade size demonstrated similar performance in force, deformation, and blade exposure.