Bhoyrul S, Mori T, Way L W
Department of Surgery, University of California, San Francisco, 513 Parnassus Avenue, San Francisco, CA 94143-0475, USA.
Surg Endosc. 1996 Jul;10(7):775-8. doi: 10.1007/s004649900155.
Trocars used in laparoscopic surgery occasionally produce serious complications, such as bleeding, visceral injury, or incisional hernia. We report the evaluation of a new, potentially safer laparoscopic access device in which the cutting obturator of a standard trocar is replaced by a blunt, radially expanding device. Conventional and radially expanding trocars were used in laparoscopic cholecystectomies in 12 pigs. Their abdominal walls were excised and the defects caused by the trocars were examined. The defects caused by the radially expanding devices were about 50% narrower (P < 0.001), and the incidence of abdominal wall bleeding was considerably less (0% vs 21%) with the radially expanding trocars. Since incisional hernias at trocar sites are related to the size of the abdominal wall defect, the use of radially expanding trocars should decrease the incidence of this complication. There should also be less risk of visceral injury.
腹腔镜手术中使用的套管针偶尔会引发严重并发症，如出血、内脏损伤或切口疝。我们报告了一种新型、可能更安全的腹腔镜接入装置的评估情况，该装置中标准套管针的切割闭孔器被一个钝头、径向扩张的装置所取代。在12头猪身上进行的腹腔镜胆囊切除术中使用了传统套管针和径向扩张套管针。切除它们的腹壁并检查由套管针造成的缺损。径向扩张装置造成的缺损窄约50%（P < 0.001），使用径向扩张套管针时腹壁出血的发生率显著更低（0%对21%）。由于套管针部位的切口疝与腹壁缺损大小有关，使用径向扩张套管针应会降低这种并发症的发生率。内脏损伤的风险也应该更低。
