title: Radially-expanding access device for laparoscopic surgery: efficacy and safety in comparison with sharp laparoscopic cannulae.
abstract: 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.