Intraabdominal pressure and incision parameters associated with a pyramidal laparoscopic trocar-cannula system and the EndoTIP cannula.
OBJECTIVE
To compare intraabdominal pressure and incision characteristics associated with insertion of a disposable pyramidal trocar-cannula system (T-CS) and the EndoTIP threaded cannula, a trocarless, reusable laparoscopic access device.


METHODS
Randomized trial (Canadian Task Force classification I).


METHODS
White swine.


METHODS
. Six insertions were created on the lower abdomen of 10 animals; changes in intraabdominal pressure associated with insertion of the pyramidal T-CS and threaded cannula were recorded by a computerized system. Once insertions were completed, skin and subcutaneous tissues were dissected to expose fascial wounds.


RESULTS
Incision length and wound area and muscle damage scores were determined. The mean change in intraabdominal pressure for the pyramidal T-CS was 4.44 mm Hg and for the threaded cannula was 2.76 mm Hg (p = 0.0001). Mean incision length, mean wound area score, and mean muscle damage score for the pyramidal T-CS were 0.968 cm, 30.9 mm(2), and 1.9/4, respectively, and for the threaded cannula they were 0.699 cm (p = 0.0082), 17.0 mm(2) (p = 0.0066), and 0.7/4 (p = 0.001), respectively.


CONCLUSIONS
In this model, insertion of the threaded cannula created less change in intraabdominal pressure and smaller fascial and muscle defects than insertion of the pyramidal T-CS.
Glass
Karen B
KB
Department of Obstetrics and Gynecology, University of California-Los Angeles, CHS Room 27-177 10833 Le Conte Avenue, Los Angeles, CA 90095-1740, USA.
Tarnay
Christopher M
CM
Munro
Malcolm G
MG
D000005:Abdomen / Q000473:pathology / Q000601:surgery; D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery; D000704:Analysis of Variance; D000818:Animals; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D007431:Intraoperative Complications / Q000517:prevention & control; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D023421:Models, Animal; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects* / Q000379:methods; D011312:Pressure; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013552:Swine