title: Evaluation of a novel trocar-site closure and comparison with a standard Carter-Thomason closure device.
abstract: OBJECTIVE
  The aim of this study was to evaluate and compare a novel trocars-site closure device, the WECK EFx™ Endo Fascial Closure System (EFx) with the Carter-Thomason CloseSure System® (CT) for the closure of laparoscopic trocar site defects created by a 12-mm dilating trocar.
  
  
  METHODS
  We created standardized laparoscopic trocars-site abdominal wall defects in cadaver models using a standard 12-mm laparoscopic dilating trocar. Trocar defects were closed in a randomized fashion using one of the two closure systems. We recorded time and number of attempts needed for complete defect closure. In addition, we recorded the ability to maintain pneumoperitoneum, endoscopic visualization, safety, security, and facility based on the surgeon's subjective evaluations. We compared outcomes for the EFx and CT closure systems.
  
  
  RESULTS
  We created 72 standardized laparoscopic trocars-site abdominal wall defects. The mean time needed for complete defect closure was 98.53 seconds (±28.9) for the EFx compared with 133.61 seconds (±54.61) for the CT (P<0.001). The mean number of attempts needed to achieve complete defect closure were 1.19 (1-3) for the EFx and 1.19 (1-2) for the CT (P=0.50). Mean scores for safety were 2.92 for EFx vs 2.19 for CT (P<0.001). Mean scores for facility were 2.97 vs 1.83 for EFx and CT, respectively (P<0.001). Mean scores for maintenance of pneumoperitoneum were 1.97 for EFx vs 2.33 for CT (P=0.022). No significant difference was observed between the EFx and the CT systems for endoscopic visualization (2.28 vs 2.50, P=0.080).
  
  
  CONCLUSIONS
  In this in vitro cadaver trial, the EFx was superior in terms of time needed to complete defect closure, safety, and facility. CT was superior in terms of maintenance of pneumoperitoneum. Both systems were equal in the number of attempts needed to complete the defect closure and endoscopic visualization.
authors.affiliation: Department of Urology, University of California , Irvine.
authors.forename: Michael
authors.initials: M
authors.lastname: del Junco
authors.forename: Zhamshid
authors.initials: Z
authors.lastname: Okhunov
authors.forename: Samuel
authors.initials: S
authors.lastname: Juncal
authors.forename: Renai
authors.initials: R
authors.lastname: Yoon
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation* / Q000706:statistics & numerical data; D002102:Cadaver; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation*; D061646:Operative Time; D011028:Pneumoperitoneum, Artificial; D013525:Surgical Instruments