Trocars: Site Selection, Instrumentation, and Overcoming Complications

Gaunay, Geoffrey S.; Elsamra, Sammy; Richstone, Lee

doi:10.1089/end.2016.0128

Cited by 12 publications

(3 citation statements)

References 64 publications

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“…Initial peritoneal access is achieved 2 cm inferior to the right/left costal margin in the midclavicular line, with either the blind (Verres Needle) access, with the open (Hasson) access or with the optical access trocar (1)(2)(3)5,6,21). The Verres technique implies CO 2 insufflation starting in the right/left subcostal area with a Verres needle up to 15 mmHg.…”

Section: Patient and Trocars Positionmentioning

confidence: 99%

Laparoscopic adrenalectomy

Raffaelli¹,

Crea²,

Bellantone³

2019

Gland Surg

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In the last three decades, endoscopic adrenalectomy has become the gold standard for the surgical treatment of most adrenal diseases. Gagner et al., first reported in 1992, the lateral trans-abdominal laparoscopic approach to adrenalectomy. Afterwards, several retrospective and comparative studies addressed the advantages of minimally invasive adrenalectomy specifically consistent in less postoperative pain, improved patients' satisfaction, shorter hospital stay and recovery time when compared to open adrenalectomy. The lateral transabdominal approach to the adrenals is currently one of the most widely used, since it allows an optimal comprehensive view of the adrenal region and surrounding structures, and provides and adequate working space. On the other hand, from a technical point of view, essential requirements for a successful laparoscopic adrenalectomy are an appropriate knowledge of retroperitoneal anatomy, a gentle tissue manipulation and a precise haemostasis technique in order to identify appropriately the structures of interest and avoid the troublesome 'oozing' that could complicate the surgical procedure.

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Section: Patient and Trocars Positionmentioning

confidence: 99%

Laparoscopic adrenalectomy

Raffaelli¹,

Crea²,

Bellantone³

2019

Gland Surg

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“…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%). 13 There are some studies which performed similar techniques to the novel Surgicel plug prior to its invention.…”

mentioning

confidence: 99%

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

Moazin

Alsuwailim

Botaiban

et al. 2023

SMJ

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‫اإلصابة‬ ‫كان‬ ‫بينما‬ .)0%( ET ‫من‬ )2.3%( ‫اجلراحية‬ ‫السدادة‬ ‫تقنية‬ ‫عند‬ ‫إحصائي‬ ‫فرق‬ ‫يظهر‬ ‫لم‬ ‫ولكن‬ ،SPT ‫من‬ )0.9%( ET ‫عند‬ ‫أكثر‬ ‫بالعدوى‬ .)p=0.064( ‫مهم‬ ‫املرتبطة‬ ‫املضاعفات‬ ‫حيث‬ ‫من‬ SPT ‫و‬ ET ‫بني‬ ‫كبير‬ ‫فرق‬ ‫يوجد‬ ‫ال‬ ‫اخلالصة:‬ ‫املنفذ.‬ ‫مبوقع‬ Objectives: To compares the endoclose technique (ET) techniques and surgicel plug technique (SPT) in terms of port-site related complications. Minimally invasive surgeries (MIS) are widely performed nowadays, nonetheless, port-site closure technique plays a role in the prevention of port-site related complications. Methods: This retrospective study was carried out at general surgery and urology departments of King Fahad Medical City, Saudi Arabia. Variables that were collected include age, gender, height, weight, body mass index, co-morbidities, type and date of surgery, Original Articleintraoperative visceral injury or bleeding, technique cost, and port-site post-operative complications (hernia, infection, bleeding, dehiscence, and hypertrophic scarring). Data was collected from electronic medical records. Patients included are whom underwent any minimally invasive procedure from the beginning of 2014 until the end of September 2020. Follow up period was at least for 2 years. Results:We analyzed 397 patients. Surgicel plug technique was more of having hernia (2.3%) than of ET (0%). While ET was more on infection (0.9%) than in SPT, but no significant difference being observed (p=0.064). Conclusion:There is no significant difference between the ET and the novel SPT in terms of port-site related complications.

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“…Urologic laparoscopic procedures have been proven to be superior to open surgery in terms of complications, convalescence, safety and efficiency, with an equivalent survival. 1 The use of laparoscopic ports or trocars is a unique component of laparoscopic surgery. The proper closure of the port site is important to prevent complications related to the port-site closure, such as port-site hernia, wound infection, wound dehiscence, and ascitic fluid leakage.…”

mentioning

confidence: 99%

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

Kim

Lee²

2019

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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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.

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Trocars: Site Selection, Instrumentation, and Overcoming Complications

Cited by 12 publications

References 64 publications

Laparoscopic adrenalectomy

Laparoscopic adrenalectomy

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

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

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