An Easy and Certain Method to Prevent Dislodging of Laparoscopic Ports

Abstract

Summary:

The dislodgement of a laparoscopic port during surgery is a common problem in patients with thin abdominal walls, especially children. In this paper, we report a new technique and a simple device to fix a laparoscopic port. The device consists of an O-ring and connecting threads that are tied to the ring at two points. The connecting thread is passed though the port's cannula, and a trocar is set in the cannula beforehand. The port with the inner trocar is placed into the abdominal cavity, and the trocar is removed. The ring is brought into the abdominal cavity with a laparoscopic forceps through the cannula. After the tip of the forceps has been passed through the ring in the abdominal cavity, the thread connected to the ring is withdrawn, and the ring is fixed on the cannula by anchoring the thread on the port extracorporeally. Such a device was used to fix a total of 95 ports during 12 laparoscopic colectomies, 7 gastrectomies, 19 cholecystectomies, 2 appendectomies, and 1 resection of Meckel's diverticulum. Four children were among these cases. Not a single port slipped off, even in cases involving infants and obese patients. No complications relating to use of this device were observed. The new stabilizing device is simple, cost effective, and useful for prevention of the dislodging of various types of conventional ports, especially in the case of infants.