Influence du type des trocarts utilisés en cœlioscopie sur la qualité du mouvement : étude expérimentale du frottement

Abstract

Objective. – To keep the pneumoperitoneum and the tightness of the abdominal and pelvic cavity during a laparoscopy, the sheaths of trocar are provided with a device (valvule, membranes etc.) inducing a friction during the handling of the instrument. The objective of this article is to analyse friction from different types of trocar’s port. Materials and methods. – We present here the experimental results obtained during a testing bench of three different trocar sheaths. The mechanism of tightness of the first trocar sheath is made of a fine membrane associated to a valve, of a thick membrane for the second trocar sheath, whereas the third trocar sheath is made of two membranes, a fine and a thick, associated to a valve. After reporting the experimental device and the analytic model adopted to describe the relationship between the measured physical parameters, we lay out our results. The identification of parameters of this model makes it possible to objectively compare the three trocars. Results. – Our results revealed that, under experimental conditions, the amplitude of friction was significantly lower with trocar’s port provided with a valve and a fine membrane than with both other ports (fivefold weaker). Discussion and conclusion. – We evoke the importance of the possible disruption brought by these frictions while referring these values to those of other measurements concerning interactions between instrument and organs. These different behaviours of the material could have some consequences in choosing the tools for the performance of precise gestures.