Comparative clinical study of port-closure techniques following laparoscopic surgery.

Abstract

Recently, a number of laparoscopic port-closure techniques have been reported to avoid the complications associated with the port closure after laparoscopic surgery. To evaluate these port-closure techniques, we compared seven new laparoscopic port-closure techniques with the standard technique of a hand-sutured closure. In a prospective, randomized study, 95, 12-mm port sites in 32 patients undergoing transperitoneal laparoscopic procedures were randomized to one of eight different port-site closure techniques. The port-closure techniques included: the Carter-Thomason Needle-Point Suture Passer, Maciol suture needle set, eXit Disposable Puncture Closure device, Endoclose suture carrier, Tahoe Surgical Instruments Ligature device, a long 14-gauge angiocatheter with looped polypropylene suture, Lowsley retractor with hand-sutured closure, and the standard technique of hand-sutured closure. We evaluated the time, the security, and the auxiliary instrumentation required for each closure. Of the port-closure techniques, the Carter-Thomason device was faster overall, resulted in fewer port-closure-related complications and provided a leak proof closure. The Carter-Thomason device is our preferred method for the closure of port sites after laparoscopic surgery.