Thus, disposable trocars do not improve the safety of laparoscopic access in case of prior abdominal surgery or abdominal sidewall adhesions. This can be explained by the insertion. When bowel loops are stuck to the abdominal wall, they may be injured whatever the type of trocar. In absence of this risk factor, disposable trocars improve the safety. The results of our study confirm that prior abdominal surgery and abdominal side wall adhesions increase the risk of trocar injury.
Specific precautions are mandatory in such cases.
Most laparoscopists suggest open laparoscopy for patients at risk of bowel adhesions. This point is currently the subject of another experimental study in our laboratory.