Tehran's Tie: A simple trick to fix the trocar to the abdominal wall and close the entry site of first trocar in laparoscopic surgery.

Abstract

Trocar dislodgment can occur frequently during minimally invasive surgery. Closing the entry port at the fascial layer after the end of a long laparoscopic surgery is time-consuming. Here, I introduce Tehran's Tie, a simple trick to overcome these problems. After the first trocar site has been created with the open technique and before the first port is inserted, the fascial wound is grasped with a loop of nylon thread, similar to a transverse matrix suture. Then, the trocar is inserted through the loop into the abdominal cavity. One thread is tied around the trocar to fix it. Another thread is used to tie and close the fascial defect at the end of laparoscopic surgery. Tehran's Tie is a simple trick for managing the first trocar site in laparoscopic surgery. It is a very useful and easy trick for fixing the first trocar to the abdominal wall and for closing the port site at the end of the procedure.