Port-site metastases are not increased by high pressure insufflation

Recent case reports of metastasis to laparoscopic trocar wounds suggest tha t laparoscopic surgery for malignancy could be associated with an increased incidence of wound metastases. Several experimental studies also support t his hypothesis. This study sought to determine whether insufflation pressur e could influence the development of port-site metastases, following laparo scopic surgery in an established animal model. 7-10 days after implantation of an adenocarcinoma in the left flank, 24 dark Agouti rats underwent lapa roscopy with intraperitoneal tumour laceration, under either low (2 mmHg) o r high (6 mmHg) insufflation pressure (12 rats in each group). All rats wer e killed 7 days after the procedure and the wounds examined for the presenc e of tumour metastasis. Three rats in the low pressure group and five rats in the high pressure group developed port-site tumours (p = 0.67). The numb er of port-site wounds which developed tumours was the same in both groups (eight per group). The development of laparoscopic port-site metastases is unlikely to be related to the insufflation pressure used during surgery.