Radially expanding trocar: A less painful alternative for laparoscopic surgery

Background and purpose: One advantage of minimal-access surgery is that it produces less pain. A radially expanding trocar has been claimed to reduce pain further. We aimed to evaluate this claim. Patients and Methods: This was a randomized controlled single-blind clinica l trial. Fifty-four patients who underwent laparoscopic cholecystectomy at the Department of Surgery, United Christian Hospital, Hong Kong, between Ju ly 1997 and September 1998 were randomized into either the study group or t he control group. The radially expanding 10-mm trocar was used for the epig astric port in the study group. The conventional 10-mm metal trocar was use d similarly in the control group. The operation was otherwise performed wit h a standardized technique. Another conventional 10-mm metal trocar was use d for the subumbilical port for all patients. Pain was measured using a vis ual analog scale. Pain scores for the epigastric port and subumbilical port were documented for 3 days after the surgery. Results: There was no difference in age, sex, diagnoses, operating time, or conversion rate. There was consistently no difference in the pain experien ced in the subumbilical wound, whereas pain at the epigastric wound was con sistently less with the radially expanding trocar (p < 0.05). Conclusion: The radially expanding trocar produces less early postoperative pain than the conventional metal trocar.