Trocar
A trocar is a medical instrument used to provide access to body cavities or organs during minimally invasive surgery, such as laparoscopy or thoracoscopy. It consists of a sharp, pointed or blunt-tipped instrument (the trocar) and a hollow tube or cannula, through which surgical instruments and cameras can be inserted.
History
The trocar has been used in medical procedures since the 19th century, primarily for the drainage of fluid collections or the removal of gas from body cavities. Over time, the design and usage of trocars have evolved to facilitate minimally invasive surgical procedures.
Design
Trocars consist of two main parts:
- The trocar – a sharp, pointed, or blunt-tipped instrument used to puncture the body cavity or organ
- The cannula – a hollow tube that remains in place after the trocar is removed, allowing for the insertion of surgical instruments and cameras
Modern trocars may also include safety features, such as a shield to protect internal organs from injury during insertion or mechanisms that reduce the risk of postoperative complications, like gas leakage or infection.
Usage
Trocars are commonly used in minimally invasive surgical procedures, such as:
- Laparoscopy – a diagnostic or therapeutic procedure used to examine or treat the abdominal or pelvic organs
- Thoracoscopy – a diagnostic or therapeutic procedure used to examine or treat the organs within the chest cavity
- Arthroscopy – a diagnostic or therapeutic procedure used to examine or treat the interior of a joint
During these procedures, the trocar is inserted through a small incision in the body wall to create an access point for surgical instruments and cameras. The cannula remains in place throughout the procedure, allowing for the exchange of instruments and the insufflation of gas to create a working space within the body cavity.
Complications
Although trocars are designed for safe use, complications can occur, including:
- Injury to blood vessels, nerves, or internal organs during insertion
- Infection
- Gas leakage
- Postoperative pain or scarring
To minimize the risk of complications, surgeons must carefully select the appropriate trocar design, insertion site, and technique for each patient and procedure.
See also
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Contributors: Prab R. Tumpati, MD