title: Cut-and-screw insertion: a method for safe and speedy secondary trocar insertion in laparoscopic surgery.
abstract: Laparoscopic surgery is increasingly applied to the treatment of gastrointestinal disease. However, the insertion of secondary trocars following pneumoperitoneum carries the risk of serious complications such as major vascular and bowel injuries. Such injury can arise when the force required for the trocar insertion is such that it causes the operator to have impaired control over the entry. There is a need for a procedure of secondary trocar insertion that is safe and easy to perform for training clinicians in laparoscopic surgery. We have developed the "cut-and-screw" insertion method for secondary trocar insertion using a specially developed laparoscopic cannula with a sharp edge and housing. Our procedure is simple, rapid, and safe. In this chapter, we describe the technique and present our initial clinical results.
authors.affiliation: Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiki
authors.forename: Tetsu
authors.initials: T
authors.lastname: Fukunaga
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Souya
authors.initials: S
authors.lastname: Nunobe
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Ohyama
authors.forename: Masanori
authors.initials: M
authors.lastname: Tokunaga
authors.forename: Akira
authors.initials: A
authors.lastname: Miki
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kuroyanagi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Seto
authors.forename: Tetsuichiro
authors.initials: T
authors.lastname: Muto
mesh_terms: D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D013525:Surgical Instruments