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Publication:

Surgical Technology International XVII - General Surgery

Article title:

Cut-and-Screw Insertion: A Method for Safe and Speedy Secondary Trocar Insertion in Laparoscopic Surgery

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Author(s)

Naoki Hiki, M.D., Ph.D.

Tetsu Fukunaga, M.D., Ph.D.

Toshiharu Yamaguchi, M.D., Ph.D.
Director

 

Souya Nunobe, M.D.

Shigekazu Ohyama, M.D., Ph.D.

 

Masanori Tokunaga, M.D.

Akira Miki, M.D.

Hiroya Kuroyanagi, M.D.

Yasuyuki Seto, M.D., Ph.D.
Vice-Director

 

Tetsuichiro Muto, M.D., Ph.D.
President, Cancer Institute Hospital

 

Gastroenterological Center, Department of Gastroenterological Surgery
Cancer Institute Hospital, Japanese Foundation for Cancer Research
Tokyo, Japan

 

Abstract

Laparoscopic surgery is increasingly applied to the treatment of gastrointestinal disease. However, the insertion of secondary trocars following pneumoperitoneum carries the risk of serious complications such as major vascular and bowel injuries. Such injury can arise when the force required for the trocar insertion is such that it causes the operator to have impaired control over the entry. There is a need for a procedure of secondary trocar insertion that is safe and easy to perform for training clinicians in laparoscopic surgery. We have developed the "cut-and-screw" insertion method for secondary trocar insertion using a specially developed laparoscopic cannula with a sharp edge and housing. Our procedure is simple, rapid, and safe. In this chapter, we describe the technique and present our initial clinical results.