Randomized trial comparing a radially expandable needle system with cutting trocars.
Sharp trocar insertion for laparoscopic procedures carries with it increased risk for vascular and visceral complications and incisional hernia. In a trial, which randomized 87 patients to treatment with either sharp trocars or a radially expanding needle system with blunt dilator, results showed that with the latter system there was statistically improved patient assessment of pain, a lower complications rate, and shorter procedure time. In the group of patients randomized to treatment with conventional trocars, there were a total of six instrument-related adverse events (6/42): four cases (five incidences) of abdominal wall injuries and one small bowel perforation caused by a Veress needle. Of the 45 patients randomized to the blunt dilator/cannula treatment, there was one adverse event (1/45) that was unrelated to the blunt dilator/cannula system: Veress needle injury to abdominal vasculature. The radially expanding access system demonstrates statistically improved patient postoperative comfort and improved patient safety.
Feste
J R
JR
Texas Women's Hospital, Houston 77054-1989, USA. JoeFeste@classic.msn.com
Bojahr
B
B
Turner
D J
DJ
D000328:Adult; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D020706:Laparoscopes / Q000009:adverse effects*; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications; D011446:Prospective Studies; D018709:Statistics, Nonparametric