Back to Journals » Open Access Surgery » Volume 9

Preclinical study evaluating a novel trocar site closure system

Authors Walker P, Shah S, Wilson E

Received 29 October 2015

Accepted for publication 15 December 2015

Published 26 April 2016 Volume 2016:9 Pages 29—35

DOI https://doi.org/10.2147/OAS.S99422

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Cataldo Doria


Peter A Walker,1 Shinil K Shah,1,2 Erik B Wilson1

1Department of Surgery, University of Texas Medical School at Houston, Houston, TX, USA; 2Michael E DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USA

Introduction: Novel trocar closure devices using subperitoneal anchor placement avoid the need for a closed loop suture, and could allow faster trocar site closure with less risk derived from less instrument penetration into the abdominal cavity while decreasing fascial ischemia and tension. We completed a series of animal experiments to compare the Carter-Thomason® suture closure device and neoClose® AnchorGuide device in order to evaluate device safety, efficacy, and ease of utilization.
Methods: A porcine model was utilized where 12 mm port sites were closed with either the Carter-Thomason® device or neoClose® AnchorGuide device. Animals were sacrificed at 14 and 56 days after trocar site closure followed by macroscopic and microscopic wound examination. A second group of animals underwent video analysis to evaluate the time required for fascial closure as well as depth of needle passage into the abdomen.
Results: All animals survived to the endpoints (14 and 56 days) without mortality or trocar site hernia. A trend towards decreased closure times was identified when using the neoClose® device (t=18.5±2.3 seconds) compared to closure with the Carter-Thomason® device (t=32.0±8.9 seconds) (P=0.153). A significant decrease in the depth of needle penetration was seen with the neoClose® device (t=31.22±1.45 mm) compared to closure with the Carter-Thomason device (t=51.0±3.1 mm) (P<0.001). Microscopic analysis showed subperitoneal anchor location at 56 days with minimal fibrosis (neoClose® device) compared to nearly complete suture degradation with deep intramuscular location (Carter-Thomason device).
Conclusion: Novel trocar closure devices could offer decreased deployment times while improving closure safety. Initial animal studies have shown that the neoClose® device yields a durable fascial closure that is easy to adopt from a technical standpoint.

Keywords: trocal closure, laparoscopy, trocar hernia, closure device

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]