Radially-expanding access device for laparoscopic surgery: efficacy and safety in comparison with sharp laparoscopic cannulae.
Until recently, access to the abdominal cavity for laparoscopic procedures has primarily required the use of sharp trocars (ST). Despite careful placement by experienced surgeons, ST-related complications have been and continue to be a serious, sometimes life-threatening problem. In 1994, a new laparoscopic access design became available that uses a Veress needle for placement, a radially-dilating expandable sleeve, and a blunt dilator and cannula. A review of evidence-based medical literature has demonstrated that this radially-expanding access (REA) device reduces the risk of abdominal-wall bleeding, major vascular injury, visceral injury, post-operative incisional hernias and deaths, as compared with any sharp trocar system. In addition, operative times have been reduced, post-operative pain reduced, and cost-savings realised.