An Overview of Trocars Types and Their Uses

In the field of medicine, trauma, and complications are always a matter of concern. Nearly one-third and one-half of all major complications happen at the time of surgical entry or preoperative procedures. To tackle this issue, an alternative method; laparoscopic surgery is used these days. It is also known by the name of minimally invasive surgery. The major surgical tools used to perform this procedure are the trocars and cannula. Our topic of concern is trocars. In this blog, we will discuss trocar types and their uses in laparoscopy.

What is Laparoscopy?

The surgeon makes a small incision in the abdominal wall for the introduction of surgical instruments in the body using the laparoscopic technique. It saves the body from large incisions as in laparotomy and makes operation much easier. It provides the following benefits over laparotomy:

· Less scaring.

· Less pain.

· Rapid recovery.

· Reduce cost.

· Fewer injuries before and after the operation.

· Shorter hospital stays.

Role of Trocars:

The first step in laparoscopy is the use of a trocar. It acts as a primary instrument, and this process refers to the primary entry. During this process, firstly, the trocar makes an incision into the body, and then carbon dioxide is blown into the peritoneal cavity to establish the pneumoperitoneum cavity.

Ports creation through Trocars:

Ports give access to laparoscopic instruments in the peritoneal cavity. Trocars help in these port’s creation.

Types of ports:

Trocars develops two types of ports, primary and secondary. The primary port positions near the umbilicus. The secondary port positions where the surgical procedure has to be taken. Generally, secondary ports are two in number with different directions. Surgeons carefully place them in line with the camera while maintaining a comfortable operating position.

Types of Trocars:

Trocars are available in a wide range of designs. Almost 100 brands and 20 manufacturing companies develop trocars on an international level. They consist of the following types:

Reusable Trocars: They are made of metal with perforations at their tips.
Disposable Trocars: They are made of plastic with bladed or non-bladed tips. Some disposable trocars contain shields over them. They automatically cover their tips before or after insertion.
Blunt Trocars: They have cone-shaped tips with perforations and blunt ends.
Cutting Trocars: They are very sharp and have different tips, such as pyramidal, conical, or excentric.
Radially Expanding Access (REA) Trocar: It has a readily expanding sleeve with the ability to extend from 5 to 12mm in diameter. It minimizes tissue trauma more than other trocars.
Optical Access Trocars: It has a feature that visualizes the cutting tip during tissue penetration.

Many other designs of trocars have been developed, such as threaded sleeves and an expandible arm. The diameter varies from 2 to 12 mm.

Trocars-Associated Complications:

Trocars have several advantages, but they also pose some harm. According to an estimate, there are 3 to 4 injuries per 1000 procedures that are due to laparoscopic trocars. It includes different types of complications such as intra-abdominal visceral injury, vascular injury, herniation, and infection.

Uses of Trocars and Cannulas:

People usually use the term trocar in conjunction with cannula. Both are part of each other; trocars are pen-shaped with triangular tips, while the cannula is a hollow cylinder inside which trocar is present. Sometimes they are used alone and others in combination. Now we will discuss the combined trocar and cannula uses.

When they are used in combination, insufflation is not required. The trocar first makes an incision in the abdominal wall and creates a way toward the abdominal cavity. Then the cannula is inserted through this way, making a pathway for other surgical instruments. In other words, we can say that they facilitate the introduction of surgical instruments into the abdomen.

Conclusion:

Laparoscopy has become an integral part of the field of surgery due to its advantages. The invention of the trocars has made it easier and provided several advantages over laparotomy. Some complications are also associated with it. Professional training and care are required for its handling.