Intraabdominal pressure and incision parameters associated with a pyramidal laparoscopic trocar-cannula system and the EndoTIP cannula.

Study Objective: To compare intraabdominal pressure and incision characteristics associated with insertion of a disposable pyramidal trocar-cannula system (T-CS) and the EndoTIP threaded cannula, a trocarless, reusable laparoscopic access device.

Design: Randomized trial (Canadian Task Force classification I).

Subjects: White swine.

Intervention: . Six insertions were created on the lower abdomen of 10 animals; changes in intraabdominal pressure associated with insertion of the pyramidal T-CS and threaded cannula were recorded by a computerized system. Once insertions were completed, skin and subcutaneous tissues were dissected to expose fascial wounds.

Measurements And Main Results: Incision length and wound area and muscle damage scores were determined. The mean change in intraabdominal pressure for the pyramidal T-CS was 4.44 mm Hg and for the threaded cannula was 2.76 mm Hg (p = 0.0001). Mean incision length, mean wound area score, and mean muscle damage score for the pyramidal T-CS were 0.968 cm, 30.9 mm(2), and 1.9/4, respectively, and for the threaded cannula they were 0.699 cm (p = 0.0082), 17.0 mm(2) (p = 0.0066), and 0.7/4 (p = 0.001), respectively.

Conclusion: In this model, insertion of the threaded cannula created less change in intraabdominal pressure and smaller fascial and muscle defects than insertion of the pyramidal T-CS.