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Slow motion shielded trocar injury analysis

Investigating the safety implications of shielded trocars used in laparoscopic surgery. High speed camera footage was captured and analysed to pinpoint the causes of intraoperative injuries to bowel and major abdominal blood vessels resulting from primary trocar insertion using the blind method. The first finding of the investigation was that the deployment of the shield mechanism was too late, only fully covering the blade after it was approximately 20mm beyond the peritoneum. Secondly the excessive force required to pierce the relatively tough skin then the progessive softening of subsequent layers coupled with the step between the trocar shield and cannula means sudden, uncontrolled movements can occur. Pork belly was used as a substitute for human flesh in this case and balloons to illustrate when the shield mechanism has failed.