Complications Associated With Optical-Access Laparoscopic Trocars

Sharp, Howard T.; Dodson, Mark K.; Draper, Michael L.; Watts, Daren A.; Doucette, Raymond C.; Hurd, William W.

doi:10.1097/00006254-200208000-00013

Cited by 5 publications

(7 citation statements)

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“…In 2008, laparoscopy was used in over 90% of the 340,000 procedures performed globally (13). Two specific drawbacks exist in laparoscopic bariatric surgery: risk of intraabdominal injuries during the passage of the first trocar through the thick abdominal wall (14–17) and the reduced formation of adhesions, allowing the small bowel to slide into mesenteric openings. The latter has created a rising demand for computed tomography (CT) scans and emergency re-laparoscopy in this increasing group of patients, an unexpected disadvantage of the laparoscopic concept.…”

Section: Discussionmentioning

confidence: 99%

Use of Laparoscopy in Gastrointestinal Surgery in Sweden 1998–2014: A Nationwide Study

Sundbom

Hedberg

2016

Scand J Surg

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Background and Aims: one by one, minimally invasive alternatives to established gastrointestinal procedures have become clinical routine. we have studied the use of laparoscopy in four common procedures-cholecystectomy, appendectomy, reflux surgery, and bariatric surgery-as well as in major resectional gastrointestinal surgery in sweden.Materials and Methods: the national patient registry was used to identify all inhospital procedures performed in patients above the age of 15 during 1998-2014, meeting our inclusion criteria. for each group, the annual number of procedures and proportion of laparoscopic surgery were studied, as well as applicable subgroups. differences in age, gender, as well as geographical differences were evaluated in the most recent 3-year period (2012-2014).Results: in total, 537,817 procedures were studied, 43% by laparoscopic approach. in 2012-2014, the proportion of laparoscopic surgery ranged from high rates in the four common procedures (cholecystectomy 81%, appendectomy 47%, reflux surgery 72%, and bariatric surgery 97%) to rather low numbers in resectional surgery (4%-10%), however, increasing in the last years. in appendectomy and cholecystectomy, men were less likely to have laparoscopic surgery (42% versus 51% and 74% versus 85%, respectively, p < 0.001). substantial geographical differences in the use of laparoscopy were also noted, for example, the proportion of laparoscopic appendectomy varied from 11% to 76% among the 21 different swedish counties.Conclusion: the proportion of laparoscopy was high in the four common procedures and low, but rising, in major resectional surgery. a large variation in the proportion of laparoscopic surgery by age, gender, and place of residence was noted.

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Section: Discussionmentioning

confidence: 99%

Use of Laparoscopy in Gastrointestinal Surgery in Sweden 1998–2014: A Nationwide Study

Sundbom

Hedberg

2016

Scand J Surg

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“…When discussing differences, potential drawbacks of laparoscopy must be held in mind. Although infrequent, there is a risk of perforating intra-abdominal structures during the blind or semi-blind entry of the abdomen (19, 20), and prospectively, internal herniation is a problem, particularly in LRYGB (21). It seems likely that the number of wound complications would be lower in patients undergoing Lap-DS, but there is little support for this idea in bariatric literature (7, 8).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy in Duodenal Switch: Safe and Halves Length of Stay in a Nationwide Cohort from the Scandinavian Obesity Registry

Edholm

Axer²,

Hedberg

et al. 2016

Scand J Surg

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“…One person lifts the abdominal wall and the other operator inserts the trocar. According to previous researches [2], inappropriate lifting of the abdominal wall would produce local pressure to cause subcutaneous bleeding, which influenced postoperative beauty. What the worst is that overshooting of the trocar may injury organs or arteries under the abdominal wall.…”

Section: Introductionmentioning

confidence: 99%

“…What the worst is that overshooting of the trocar may injury organs or arteries under the abdominal wall. It leads to complications such as hemodynamic shock, respiratory arrest and even death [2][3][4]. Approximately 75,000 inadvertent trocar insertion occur annually in the U.S. alone [2]- [4].…”

Section: Introductionmentioning

confidence: 99%

“…It leads to complications such as hemodynamic shock, respiratory arrest and even death [2][3][4]. Approximately 75,000 inadvertent trocar insertion occur annually in the U.S. alone [2]- [4]. Currently techniques for accessing specific regions of the body with trocars, needles and catheters typically involve blind guidance where the physician or nurse relies entirely on tactile feedback and experience.…”

Section: Introductionmentioning

confidence: 99%

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A Novel Device for Safe Trocar Insertion in Laparoscopic Surgery Based on the Insertion Force Characteristics

Sun¹,

Tadano²

2019

IJBBB

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Overshooting of trocar insertion in laparoscopic surgery has been extensively cited as a major cause of surgical injuries. Besides, the complexity and large insertion force of the current handheld insertion method also increase the risk of overshooting and difficulty for novices or female operators. Hence, we developed this trocar insertion device to make trocar insertion easier and safer. The device is designed easy to handle and trocar-assembling. And we used negative pressure and pneumatic cylinders to lift the abdominal wall and two motors to drive the trocar insertion. In addition, we interpreted the characteristics of insertion force and proposed an algorithm to detect whether it has penetrated out. With this algorithm the device can stop inserting automatically and immediately. The development of this device realized the automation of trocar insertion. It reduced the demand for operators and improved the safety of this procedure.

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Complications Associated With Optical-Access Laparoscopic Trocars

Cited by 5 publications

References 0 publications

Use of Laparoscopy in Gastrointestinal Surgery in Sweden 1998–2014: A Nationwide Study

Use of Laparoscopy in Gastrointestinal Surgery in Sweden 1998–2014: A Nationwide Study

Laparoscopy in Duodenal Switch: Safe and Halves Length of Stay in a Nationwide Cohort from the Scandinavian Obesity Registry

A Novel Device for Safe Trocar Insertion in Laparoscopic Surgery Based on the Insertion Force Characteristics

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