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Analysis of Abdominal Wounds Made by Surgical Trocars Using Functional Luminal Imaging Probe (FLIP) Technology

Center for Visceral Biomechanics and Pain, Aalborg Hospital, Aalborg, Denmark, Department of Medical Physics & Clinical Engineering, Adelaide & Meath Hospital, Tallaght, Dublin, Ireland

Deidre O'Donovan, MD, PhD

Department of Medical Physics & Clinical Engineering, Adelaide & Meath Hospital, Tallaght, Dublin, Ireland

Donghua Liao, PhD

Center for Visceral Biomechanics and Pain, Aalborg Hospital, Aalborg, Denmark

Jingbo Zhao, MD, PhD

Center for Visceral Biomechanics and Pain, Aalborg Hospital, Aalborg, Denmark

Rich Schiretz, M Eng

Covidien Surgical Devices, North Haven, Connecticut

Russell Heninrich, M Eng

Covidien Surgical Devices, North Haven, Connecticut

Hans Gregersen, MD, MPM

Center for Visceral Biomechanics and Pain, Aalborg Hospital, Aalborg, Denmark, hg{at}rn.dk

The aim was to use a novel functional luminal imaging probe for evaluation of wound defects and tissue damage resulting from the use of trocars. Following general anesthesia of 4 adult pigs, 6 different trocars were randomly inserted at preselected locations in the porcine abdominal wall. The functional luminal imaging probe was used to profile the trocar holes during bag distension from 8 axial cross-sectional area measurements. The cross-sectional areas and pressure in the bag were recorded and exported to Matlab for analysis and data display. Geometric profiles were generated, and the minimum cross-sectional area and hole length (abdominal wall thickness) were used as endpoints. Successful distensions were made in all cases. The slope of the contours increased away from the narrowest point of the hole. The slope increased more rapidly toward the inner abdominal wall than toward the outer wall. The slope of the linear trend lines for the cross-sectional area—pressure relation represents the compliance at the narrowest point in the wall. The hole length (abdominal wall thickness) could be obtained at different cross-sectional area cutoff points. A cutoff point of 300 mm² gave good results when compared to the length of the hole measured after the tissue was excised. This technique represents a new and straightforward way to evaluate the effects of trocars on the abdominal wall. It may also prove useful in comparing techniques and technology from different manufacturers.

Key Words: FLIP • trocars • tissue damage • geometry

Surgical Innovation, Vol. 15, No. 3, 208-212 (2008)
DOI: 10.1177/1553350608321317


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