Investigation of the Effectiveness of the Radially-Expanding Needle System, in Contrast to the Cutting Trocar in Enhancing Patient Recovery

Abstract

Conventional cutting trocars used in laparoscopic surgery occasionally produce serious intra-operative complications and increased postoperative pain. In previous randomised prospective studies comparing the newer radially-expanding needle system (Step) with the cutting trocar, pain scores were significantly lower in the Step group. In this prospective, randomised, multicentre study conducted at three institutions, 100 patients were assigned to treatment with either cutting trocars or the blunt Step system. A total of 49 patients were randomly assigned to the Step system and 51 patients were randomly assigned to trocars. Patients were asked to rate their pain using a 101 -Visual Analogue Scale at 4, 8, 12, 24 and 72 h after surgery. There was a statistically-significant pain reduction with the Step system. The mean postoperative pain scores were consistently lower in the Step group; this was most apparent at 4, 8 and 12 h (p = 0.05). Differences in operative time and adverse events were not statistically significant. In contrast to the conventional cutting trocar, the Step radially-expanding needle system leads to a statistically-significant improvement of patient postoperative comfort.

Key Words:

• laparoscopy
• radially expanding needle system