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Trocar Size Selection for Trans-Trocar Appendix Removal in Laparoscopic Appendectomy
Journal of Minimally Invasive Surgery 2014³â 17±Ç 1È£ p.1 ~ p.4
Á¤º¸¿µ(Jung Bo-Young) - µ¿±¹´ëÇб³ °æÁÖº´¿ø ¿Ü°ú
¹èÁ¤¹Î(Bae Jung-Min) - ¿µ³²´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
Abstract
Purpose: Many disposable laparoscopic instruments are used in laparoscopic surgery. There are several disadvantages in use of disposable laparoscopic instruments, including cost in-effectiveness, environmental contamination, and resource recycling. In addition, a disposable specimen bag has been used in laparoscopic appendectomy. Use of the trans-trocar appendix removal technique provides several advantages compared to use of a specimen bag. Therefore, the aim of this study is to analyze the adequate trocar size for trans-trocar appendix removal.
Methods: A total of 62 patients undergoing appendectomy between June 2012 and September 2012 were identified. After appendectomy, we performed a trans-trocar test using re-moved appendix specimen and trocars. Three different types of trocars were used for the trans-trocar test, 5 mm, 12 mm, and 11 mm Xcel? (Ethicon). We analyzed the success rate.
Results: Significant relationships were observed between maximal specimen diameter and body mass index. When BMI was below 20, the success rate of the 11 mm trocar was 86% in the trans-trocar appendix removal test. When BMI was between 20 and 25, the success rate of the 12 mm trocar was 71%, but that of 11 mm was 57%. When BMI was above 25, the success rate of the 15 mm trocar was 62%.
Conclusion: Although this study had many limitations, a large-sized trocar was needed for trans-trocar appendix re-moval in more body mass index. When BMI is below 20, an 11 mm trocar is recommended in trans-trocar appendix removal. When BMI is between 20 and 25, a 12 mm trocar is. When BMI is above 25, a 15 mm trocar and a disposable specimen bag are recommended. Further continuous study will be needed for analysis of clinical outcome.
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Laparoscopy, Appendectomy, Trocar
KMID :
1035920140170010001
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