Department of General Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Faculty of Medicine, Hebrew University of Jerusalem, Israel.
Minim Invasive Ther Allied Technol. 2022 Apr;31(4):567-572. doi: 10.1080/13645706.2021.1871630. Epub 2021 Jan 17.
Easy and safe methods of fascia closure are needed in order to reduce the risk for trocar site hernias without affecting procedure time significantly. Here we present a method for port site closure using heat induced collagen denaturation.
Controlled heat-induced collagen denaturation was applied to laparoscopic trocar sites in living porcine animal models. These were compared to control trocar sites which were left open. Port sites were evaluated visually at days 14 and 28 after the procedure, and both visually and pathologically at post-procedural day 42.
A total of 12 port sites were evaluated in three pigs. No incisional hernias were noted at any of the trocar sites in both groups. Histological evaluation revealed that one of the six control ports appeared to have a complete transfascial defect, whereas none of the study group trocars showed this finding. Furthermore, the study port sites showed a more robust scarring pattern.
Heat-induced collagen denaturation in this preliminary study was found to be safe and allowed better scarring of the healing port sites. We believe that this technology may offer a safe and efficient closure of laparoscopic trocar sites. More studies are needed to further evaluate the true effectiveness of this technology.
为了降低套管部位疝的风险，需要使用简单且安全的筋膜闭合方法，同时又不显著延长手术时间。在此，我们介绍一种使用热诱导胶原蛋白变性来闭合套管部位的方法。
在活体猪动物模型中，对腹腔镜套管部位应用受控热诱导胶原蛋白变性。将这些套管部位与未闭合的对照套管部位进行比较。术后 14 天和 28 天对套管部位进行肉眼评估，并在术后第 42 天进行肉眼和病理评估。
在三只猪中总共评估了 12 个套管部位。在两组中，没有观察到任何套管部位出现切口疝。组织学评估显示，对照组的 6 个套管中有一个似乎存在完全的筋膜缺损，而研究组的套管均未发现这种情况。此外，研究组的套管部位显示出更健壮的瘢痕形成模式。
在这项初步研究中，热诱导胶原蛋白变性被发现是安全的，并允许套管部位更好地愈合。我们相信这项技术可能为腹腔镜套管部位的安全有效的闭合提供一种选择。需要进一步的研究来进一步评估这项技术的真正效果。
