The insertion of a trocar during laparoscopic abdominal or pelvic surgery can result in injuries to bowel, vessels or other structures. The risk of trocar injury is greater is certain factors are present.
Patients at risk for blind trocar insertion:
(1) history of prior abdominal surgery
(2) child
(3) small, thin adult
(4) lower abdominal skin that cannot be adequately stabilized for safe insertion of the Verres needle or trocar to achieve pneumoperitoneum
Surgeon-related risk factors associated with trocar injuries:
(1) delay in making the diagnosis of an injury
(2) not having adequate resources available in the event of a trocar injury
(3) incomplete familiarity with how to use a particular trocar
(4) excessive fatigue
(5) excessive force during trocar insertion
(6) inexperience
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