Port-Site Closure Using a Modified Aptos Needle

Abstract

A modified Aptos needle appeared to allow an easy, simple, safe method for fascial closure of trocar sites.

Percutaneous trans‐abdominal external looped needle with two holes in the trocar sheath for port‐site closures in difficult obese cases

“…Port closure techniques were classified by Shaher into three groups : (i) techniques that use assistance from inside the abdomen (requiring two additional ports); (ii) techniques that use extracorporeal assistance (requiring one additional port); and (iii) techniques that can be performed with or without visualization (without additional ports). Also, some surgeons recommended the use of fascial closure devices such as a spinal needle, tip hole needle, double‐tip needle, and Carter‐Thomason needle . The procedures outlined by Shaher are difficult and often do not result in good fascial closure of the port site in obese cases (i.e.…”

Severe Complications of Laparoscopic Surgery as a Result of Incorrect Abdominal Wall Closure

“…The appearance of hernias in laparoscopic trocar incisions is a complication unresolved, with an incidence between 1 and 6% [1][2][3]. We present case reports of two patients who presented early life-threatening site hernias.…”

“…To prevent from trocar site hernias the current recommendation is the 10 mm or larger defects closure [1][2][3][4][5]. Special care must be taken in patients with risk factors for trocar site hernia as advanced age [5,6], wound infection [4,[6][7] and obesity [4][5][6][7].…”

Prevención de las hernias en el sitio del trocar: un problema pendiente de solución. Revisión y experiencia personal con una nueva técnica

“…Las técnicas de cierre directo fascial han sido las primeras en utilizarse, pero son métodos con mala visualización y, en ocasiones, bastante incómodos a través de estas incisiones tan reducidas. Además, se consideran procedimientos toscos, que aumentan el tiempo quirúrgico, causan dolor local, empeoran el resultado estético final y pueden comprometer la seguridad del cierre en los pacientes obesos [14][15][16] . Si seguimos los principios para reparar una hernia incisional, parece lógico aceptar que la mejor profilaxis debería considerar el uso de prótesis, como aceptan muchos cirujanos para prevenir las hernias incisionales o paraestomales, especialmente en pacientes considerados de alto riesgo.…”