Safety and efficacy of 12‐mm radial dilating ports for laparoscopic access

Rubenstein, Jonathon N.; Blunt, Lynn W.; Lin, Weigan; User, Herbert M.; Nadler, Robert B.; Gonzalez, Christopher

doi:10.1046/j.1464-410x.2003.04339.x

Cited by 11 publications

(3 citation statements)

References 24 publications

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“…However, controversy exists as others suggest that bladeless trocars, including the 12 mm ports, do not necessitate routine fascial closure. Rubenstein and colleagues reported no incisional hernias when they did not close the fascia of 12 mm ports in 112 port sites [ 27 ]. Additionally, Kang et al reported no lateral 12 mm port site hernia in 498 patients where only the fascia of 12 mm midline port site was closed [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

Chennamsetty

Hafron

Edwards

et al. 2015

Advances in Urology

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Introduction. To explore the long term incidence and predictors of incisional hernia in patients that had RARP. Methods. All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair. Results. Of 577 patients, 48 (8.3%) had a hernia at an incisional site (35 men had umbilical), diagnosed at (median) 1.2 years after RARP (mean follow-up of 5.05 years). No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams; P = 0.001) and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48) versus 4.6% (22/480); P = 0.033). Overall, 4% (23/577) of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias. Conclusion. Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.

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Section: Discussionmentioning

confidence: 99%

Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

Chennamsetty

Hafron

Edwards

et al. 2015

Advances in Urology

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“…Typically, four radial-dilating ports are placed. The radial dilating ports have an improved safety profile over older cutting-type ports [20]. After pneumoperitoneum is obtained, a uterine manipulator such as the ZUMIR (Cooper Surgical) is placed in conjunction with a KohR colpotomy (Cooper Surgical) ring and a vaginal pneumo-occluder balloon.…”

Section: Laparoscopic Staging Technique In Endometrial Cancermentioning

confidence: 99%

Laparoscopic technology for the treatment of endometrial cancer

Kueck

Gossner

Burke

et al. 2006

International Journal of Gynecology & Obstetrics

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“…Other techniques, used less frequently and with limited supporting evidence [6] are direct entry [51][52][53][54][55][56][57][58][59], optical access trocars [60][61][62][63][64][65][66][67][68][69][70], and radially expanding trocars [71][72][73][74][75][76].…”

mentioning

confidence: 99%

Laparoscopic entry techniques: clinical guideline, national survey, and medicolegal ramifications

Varma

Gupta

2008

Surg Endosc

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Background This study aimed to establish criteria for safe laparoscopic entry through a systematic literature search and evidence-based medicine appraisal, to determine surgeon preferences for laparoscopic entry in the United Kingdom, and to appraise the medicolegal ramifications of complications arising from laparoscopic entry. Methods A systematic literature search of MEDLINE and EMBASE (1996-2007) was performed as well as a national surgeon survey by questionnaire (May-December 2006). Results Laparoscopic entry criteria involving 10 steps were established based on the systematic literature search and evidence-based critical appraisal. The national survey had 226 respondents, with the majority aware of the Middlesbrough consensus or Royal College of Obstetricians and Gynaecologists [RCOG]-sourced guidance. There was considerable variation in preferred laparoscopic entry techniques. Currently, there is clear judicial guidance on the medicolegal stance toward laparoscopic entry-related complications. Conclusions Despite widespread awareness of laparoscopic entry guidelines, there remains considerable variation in the techniques adopted in clinical practice. Unless practice concurs with recommended guidance, women undergoing laparoscopy will be exposed to increased unnecessary operative risk. Laparoscopic entry-related injury in an uncomplicated woman is considered negligent practice according to UK legal case law.

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Safety and efficacy of 12‐mm radial dilating ports for laparoscopic access

Cited by 11 publications

References 24 publications

Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

Laparoscopic technology for the treatment of endometrial cancer

Laparoscopic entry techniques: clinical guideline, national survey, and medicolegal ramifications

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