The Laparoscopic Sound: A Simple Instrument for Rapid and Safe Secondary Trocar Insertion in Retroperitoneal Laparoscopy

Abstract

In retroperitoneal laparoscopic surgery, the insertion of secondary trocars results sometimes in serous complications that may spoil the entire procedure. To obviate this problem we report our initial experience with the use of a new instrument. The instrument has the basic characteristics of a urethral sound but is larger, longer and with more prominent curve. The tip of the laparoscopic sound has been designed to have a slightly smaller diameter than the inner diameter of the 10-mm trocar sheath, so that they can fit together. With proper pull-through manipulations, the trocar sheath is inserted into the retroperitoneal space rapidly and safely. No complications arose due to trocar placement. No gas leak was noticed in any of the patients, nor was any peritoneal tearing, vascular injury or muscular splitting observed. The method represents an important progress in the technique of inserting secondary trocars and creating the retroperitoneal space due to its simplicity, safety, rapidity, low cost and effectiveness.