Endoscopic Threaded Imaging Port (EndoTIP) for laparoscopy: Experience with different body weights

Background: A laparoscopic access system was developed for primary port ins ertion. The cannula requires no trocar and no axial penetration force durin g insertion. It provides magnified visualization through the scope on the m onitor during access and exit. The device has a proximal valve section and a distal cannula section with a single thread winding around its outer surf ace, ending in a blunt tip. After umbilical incision and Veress insufflatio n, a 0 degrees laparoscope is mounted in the cannula. The tip of the cannul a is inserted into a tiny fascial incision and rotated clockwise. The fasci a and then the muscle fibers spread radially and are transposed onto the ca nnula's outer thread. The thin peritoneum transilluminates; bowel, vessels, and/or adhesions are visualized before entry into the peritoneum. Methods: The cannula was used in 234 consecutive patients: 8.1% were marked ly obese, with a body mass index (BMI) greater than or equal to 35, 14.8% w ere moderately obese (BMI 30 to <35), and 77.1% were mildly obese or normal (BMI <30). Results: There were no instrument-related or insertion-related complication s. No insertion failed. Insertion time was slightly longer in the morbidly obese patients who had had previous umbilical surgical incisions. No port-s ite hernias have been found thus far (follow-up 6-48 months). Conclusion: This reusable cannula was found to be safe for any body weight.