Management of abdominal gas leakage from surgical trocars in laparoscopic surgery: a preclinical study.

Introduction: There is an ongoing concern about the potential infectious risk due to pneumoperitoneal gas leakage from surgical trocars in laparoscopic surgery. We aimed to visually confirm the presence of leakage from trocars and investigate the changes in the leakage scale according to intra-abdom...

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Published in:Minimally Invasive Therapy & Allied Technologies Vol. 32; no. 4; pp. 183 - 190
Main Authors: Hayashi, Yoshinori, Ishii, Yuji, Ishida, Tomo, Yamashita, Kotaro, Saito, Takuro, Tanaka, Koji, Yamamoto, Kazuyoshi, Makino, Tomoki, Takahashi, Tsuyoshi, Kurokawa, Yukinori, Eguchi, Hidetoshi, Doki, Yuichiro, Nakajima, Kiyokazu
Format: pictorial research tables/charts Journal Article
Published: Taylor & Francis Ltd Aug2023
Online Access:View this record in EBSCOhost
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      dt: Aug2023
      vid: 32
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      pub: Taylor & Francis Ltd
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        10.1080/13645706.2023.2211661
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        atl: Management of abdominal gas leakage from surgical trocars in laparoscopic surgery: a preclinical study.
      aug:
        au:
          Hayashi, Yoshinori
          Ishii, Yuji
          Ishida, Tomo
          Yamashita, Kotaro
          Saito, Takuro
          Tanaka, Koji
          Yamamoto, Kazuyoshi
          Makino, Tomoki
          Takahashi, Tsuyoshi
          Kurokawa, Yukinori
          Eguchi, Hidetoshi
          Doki, Yuichiro
          Nakajima, Kiyokazu
        affil: Department of Next Generation Endoscopic Intervention (Project ENGINE), Graduate School of Medicine, Osaka University, Osaka, Japan
      sug:
        subj:
          Surgery, Laparoscopic Adverse Effects
          Surgical Instruments Adverse Effects
          Pneumoperitoneum Risk Factors
          Risk Assessment
          Animal Studies
          Swine
          Pneumoperitoneum Prevention and Control
          Surgical Instruments Classification
          Image Processing, Computer Assisted
          Intra-Abdominal Hypertension
          Aerosols
          Smoke, Surgical
          Patient Safety
      ab: Introduction: There is an ongoing concern about the potential infectious risk due to pneumoperitoneal gas leakage from surgical trocars in laparoscopic surgery. We aimed to visually confirm the presence of leakage from trocars and investigate the changes in the leakage scale according to intra-abdominal pressures and trocar types. Material and methods: We established a porcine pneumoperitoneum model and performed experimental forceps manipulation using 5-mm grasping forceps with 12-mm trocars. The gas leakage, if any, was imaged using a Schlieren optical system, which can visualize minute gas flow invisible to the naked eye. For measuring the scale, we calculated the gas leakage velocity and area using image analysis software. Four types of unused and exhausted disposable trocars were compared. Results: Gas leakage was observed from trocars during forceps insertion and removal. Both the gas leakage velocity and area increased as the intra-abdominal pressure increased. Every type of trocar we handled was associated with gas leakage, and exhausted disposable trocars had the largest scale gas leakage. Conclusions: We confirmed gas leakage from trocars during device traffic. The scale of leakage increased with high intra-abdominal pressure and with the use of exhausted trocars. Current protection against gas leakage may not be sufficient and new surgical safety measures and device development may be needed in the future.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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