A new technique for laparoscopic trocar site closure: feasibility study and comparison with a previously described method in pigs.

Background: Laparoscopic trocars create small defects through which the bowel or omentum can herniate. Closure of such small wounds can be difficult and many techniques and devices have been developed for port sites closure. The aim of this study is to describe a new method for trocar site closure in pigs and to compare it with a previously described technique. Materials and methods The new technique uses the trocar sheath to guard a curved needle passed transcutaneously with the abdomen inflated. The suture is then retrieved subcutaneously and tied. The feasibility and effectiveness of the new proposed technique was evaluated and compared with a previously described technique that uses the trocar sheath and retractors to pass a ski-needle in the fascia. Both techniques were evaluated on small(9 kg) and larger dead pigs(40 kg) for the ability in closing abdominal layers. Healing of 5 mm and 10 mm trocar site wounds closed with both techniques was then compared in 8 live animals(40 kg). Results Both techniques allowed closure of all layers in small pigs but only the new proposed technique allowed closure of all layers in animals with a thicker abdominal wall. In live animals healing of trocar wounds was complete at 8 days postoperatively, unregarding of trocar size or technique used. Discussion Both techniques can be performed without specific instruments and are fast and inexpensive. Only the new proposed technique can be performed with the abdomen inflated and allows closure of all layers in animals with thick preperitoneal and subcutaneous fat.