Authors: B Böhm M Knigge M Kraft K Gründel U Boenick
Publish Date: 2014/03/18
Volume: 12, Issue: 12, Pages: 1434-1438
Abstract
Most trocars currently used to place a cannula through the abdominal wall have a conical or pyramidal tip Because the risk of inadvertent injury along with removal of the cannula is probably related to a the force needed to traverse the abdominal wall b the force needed to remove the trocar and c the defect in the abdominal wall the optimum configuration of the penetrating tip should be determined The entry force needed to perforate the abdominal wall the removal force necessary to remove the trocar and the defect in the abdominal wall were measured in a porcine model under standardized conditions general anesthesia 12 mmHg pneumoperitoneum Nineteen trocars six disposable seven reusable six custommade have been tested They were divided into six groups according to the shape of the tip conical pyramidal or a combination The entry force F= 256 p 00001 and the removal force F= 51 p 001 were related to the shape of the tip Conical tips needed a higher force than purely pyramidal tips The abdominal defect was also different between groups F= 65 p 0001 The trocar with a pyramidal shape caused a greater defect than conical tips The defect in the abdominal wall was inversely related to the entry force r=−055 p 0001 and to the removal force r=−057 p 0001 There is not an optimum configuration of a simple pushthrough trocar with a low entry force and a high removal force Some kind of a conical tip is recommended for insertion of trocars under direct view
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