Skip to main content
main-content

01.03.2012 | Ausgabe 3/2012

Surgical Endoscopy 3/2012

Radially expanding laparoscopic trocar ports significantly reduce postoperative pain in all age groups

Zeitschrift:
Surgical Endoscopy > Ausgabe 3/2012
Autoren:
Simon C. Mordecai, Oliver W. N. Warren, Stephen J. Warren

Abstract

Background

Trocar entry points have been identified as a significant source of pain after laparoscopic surgery. This is particularly true of the larger 12-mm ports that require deep fascial closure to avoid port-site herniation. We investigated whether using radially expanding trocars not requiring fascial closure compared to conventional cutting trocars for the 12-mm port in transabdominal preperitoneal (TAPP) hernia repairs had any effect on postoperative analgesic requirements and return to work or normal activity.

Methods

The number of days analgesia was required postoperatively and the number of days taken to return to normal activity was recorded for 143 consecutive patients who underwent TAPP hernia repair by a single experienced laparoscopic surgeon. Exactly the same operative technique was used in these patients with the exception of the 12-mm port site entry. In group 1 (104 patients), a conventional cutting trocar was used requiring deep fascial closure. In group 2 (39 patients), a radially expanding trocar was used and the fascial defect was not closed.

Results

Analgesia was required for an average of 10.5 days in group 1 and 2.4 days in group 2 (P < 0.001). The average time to return to work or to normal activity was 23.4 days in group 1 and 15.6 days in group 2 (P = 0.004). There was no significant difference between the two groups with respect to the patients’ age, sex, or operating time.

Conclusion

Using the laparoscopic TAPP hernia repair as a standardised operation, changing from 12-mm fascial port closure to a technique that uses port dilation (not requiring a potentially “tight” deeper fascial closure) in a similar group of patients shows that there is a significant reduction in postoperative analgesic requirement and an earlier return to productive work or normal lifestyle. Perhaps dilating ports should replace those larger 10-, 12-, and 15-mm ports that require deeper sutures in all laparoscopic surgical operations.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Jetzt e.Med zum Sonderpreis bestellen!

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 3/2012

Surgical Endoscopy 3/2012 Zur Ausgabe
  1. Sie können e.Med Chirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise