Clinical and laboratory evaluation of an electrosurgical laparoscopic trocar.
Electrosurgical energy may be utilized as an adjunct to mechanical force for insertion of laparoscopic trocars. The advantage of this approach may be better operator control of insertion, with less risk of intraperitoneal and retroperitoneal injury. To assess the safety and efficacy of electrosurgical trocars, we compared them to mechanical trocars in clinical and animal trials. During 100 trocar introductions in 25 laparoscopic cholecystectomies, insertion force was measured. In contrast to mechanical trocars, which required progressively more force to insert as size increased, electrosurgical trocars required the same low insertion force regardless of size. No wound complications occurred. In animal experiments, wound healing (measured histologically and by bursting strength) was normal and equivalent for mechanical and electrosurgical insertions. We conclude that electrosurgical trocars require less force for insertion and do not impair wound healing. Electrosurgical trocars may thus offer important safety advantages over mechanical trocars.
Waxman
K
K
Department of Surgery, University of California Irvine Medical Center, Orange 92668.
Birkett
D H
DH
Sackier
J M
JM
Este-McDonald
J
J
Duquette
J
J
D000009:Abdominal Muscles / Q000601:surgery; D000818:Animals; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation; D004566:Electrodes; D004598:Electrosurgery / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D004869:Equipment Safety; D005069:Evaluation Studies as Topic; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects; D008422:Materials Testing; D010537:Peritoneum / Q000601:surgery; D011677:Punctures / Q000295:instrumentation; D011817:Rabbits; D013193:Stainless Steel; D013314:Stress, Mechanical; D014945:Wound Healing
D013193:Stainless Steel