Prospective Randomized Control Study on the Efficiency and Safety of a Novel Port-site Closure Device, the EZ-close Port-site Closure System

Abstract

The efficiency and safety of EZ-close Port-Site Closure System were investigated in comparison with those of the Carter-Thomason CloseSure System (CT) device.Methods: This was a prospective randomized control study. The primary outcome was the time taken to complete the closure of the port site using either the EZ or CT. The suture time (mean ± SD) for the EZ group was significantly less than that of the CT group (36.8 ± 10.1 s for the EZ group vs. 48.9 ± 21.5 s for the CT group, P = 0.004). There was no need for additional instruments in the EZ group, but in 84.6% of the patients in the CT group, a grasper was required to hold the tie (P < 0.05). There was no difference in the complication rates between the 2 groups. Conclusions:The EZ device showed an improved efficiency and similar safety compared with that of the CT device. Its main advantage lied in enabling the surgeon to be totally self-sufficient for the whole port-site closing procedure.

Evaluation of a Novel Trocar-Site Closure Device in Laparoscopic Surgery

“…Several previous studies were designed to compare the conventional Carter-Thomason device with the various novel trocar-closure systems. 7,14,17 However, in this study we used the hand suturing method for the control group because the majority of trocar site closures in laparoscopic colorectal surgery are performed by hand suturing in South Korea, including in our institution. Thus, we focused on the comparison of EZ-Close TM with manual closure in terms of time efficiency according to the BMI stratification.…”

“…As trocar-site hernia rarely occurs, most previous studies evaluating trocar-site closure devices reported no postoperative herniation in a small population of patients. 7 , 14 – 15 Trocar-site hernia is associated with obesity, duration of surgery, age, diabetes mellitus, incision enlargement, and wound infection; thus, proper fascial closure is even more essential in patients with those risk factors. 16 …”

“…According to an in vitro study in cadaver models, the mean closure time of the conventional Carter-Thomason system was 133.6 ± 54.6 s. 17 Another study reported that the Carter-Thomason needle technique took an average of 8 min to close two 10-mm port sites, although the time of complete skin closure was counted. 15 However, several recent studies demonstrated that the mean closure time with the Carter-Thomason device was approximately 30–50 s. 7 , 14 Even if the same conventional device was used in each study, the significant difference in closure time was probably due to the different criteria for measuring the suture time or the difference in the surgeon's skill level. In our study, all of the wound closure procedures were performed by 3 rd and 4 th year general surgical residents who had no previous experience with EZ-Close TM .…”

Surgicel plug technique versus endoclose technique for port-site closure post minimally invasive (robotic and laparoscopic) surgeries

“…1 Multiple techniques have been invented over the past decades that uses different approaches and devices for port-sites closure; complications at port-sites post-operatively are varied among those techniques including hernia, bleeding, infection, dehiscence and hypertrophic scar. [2][3][4][5] Endoclose technique is one of the widely performed techniques worldwide that is Fast, straightforward, and result in low complication rate. [6][7][8][9] Surgicel material is an absorbable hemostatic agent that is commonly used to stop bleeding.…”

“…For the need of additional instrument, unlike CT group, there was no need for additional instrument in the EZ-close group. 2 Some other authors also stated the necessity of using additional instruments with CT device. 9,15 For the Surgicel plug, Moazin et al 13 study which was done on 114 patients resulted in 1 case of hernia (0.8%) and 2 cases of non-infectious discharge (1.7%).…”