• James Fanning, Manish Shah, and Bradford Fenton.
• Department of Obstetrics and Gynecology, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA 17033, USA. jfanning1@hmc.psu.edu
• JSLS. 2011 Jan 1; 15 (1): 59-61.

Background And ObjectivesTrocar insertion injury has a high morbidity, mortality, and cost. The purpose of this study was to compare standard trocar entry with our reduced-force closed trocar entry technique by measuring trocar insertion force using a mechanical force gauge.MethodsIn the operating room, the force gauge was inserted into a sterile glove and connected to the proximal portion of the trocar to measure insertion force. Through one incision, we used a standard closed trocar entry, while through the other incision, we used our reduced-force closed trocar entry technique. After making the skin incision and before trocar entry, we spread and dilated the skin, subcutaneous tissue, fascia, and muscle with a hemostat.ResultsTwenty-five patients entered the trial and none were excluded. Median trocar insertion force was 3.3lb (range, 1.6 to 5.4) with our reduced-force trocar entry technique versus 6.5lb (range, 2.0 to 14.0) with the standard trocar entry (P=.001). No complications occurred with the reduced-force trocar entry technique.ConclusionOur reduced-force trocar entry technique decreases trocar insertion force by 50%, requires no additional instruments or cost and is fast and safe. Reduced-entry force pressure may decrease the risk of trocar insertion injury.

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