1. Sutureless energy-based wound closure: a step in the quest for trocar site hernia prevention
- Author
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Jonathan B. Yuval, Giora Kornblau, Yoav Mintz, Mahmoud Abu Gazala, David Maier Neustadter, and Ronit Brodie
- Subjects
medicine.medical_specialty ,Hernia ,Swine ,Trocar site hernia ,Closure (topology) ,Port site ,Cicatrix ,03 medical and health sciences ,0302 clinical medicine ,Animals ,Medicine ,Procedure time ,business.industry ,Fascia ,Surgical Instruments ,Trocar site ,Laparoscopes ,Surgery ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Energy based ,Laparoscopy ,030211 gastroenterology & hepatology ,Wound closure ,business - Abstract
Easy and safe methods of fascia closure are needed in order to reduce the risk for trocar site hernias without affecting procedure time significantly. Here we present a method for port site closure using heat induced collagen denaturation.Controlled heat-induced collagen denaturation was applied to laparoscopic trocar sites in living porcine animal models. These were compared to control trocar sites which were left open. Port sites were evaluated visually at days 14 and 28 after the procedure, and both visually and pathologically at post-procedural day 42.A total of 12 port sites were evaluated in three pigs. No incisional hernias were noted at any of the trocar sites in both groups. Histological evaluation revealed that one of the six control ports appeared to have a complete transfascial defect, whereas none of the study group trocars showed this finding. Furthermore, the study port sites showed a more robust scarring pattern.Heat-induced collagen denaturation in this preliminary study was found to be safe and allowed better scarring of the healing port sites. We believe that this technology may offer a safe and efficient closure of laparoscopic trocar sites. More studies are needed to further evaluate the true effectiveness of this technology.
- Published
- 2021
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