How it works
Step 01
Trocar inserted into port site opening to depth of markings (observed from telescope in another port).
Step 02
Needle carrying the suture pushed through trocar conduit, muscle tissue and into the abdominal cavity.
Step 03
Needle withdrawn to create loop to be grabbed by forceps from a different port.
Step 04
One end of suture pulled through into abdominal cavity with forceps.
Step 05
Needle withdrawn from trocar.
Step 06
Trocar pulled outwards to reveal lower opening of conduit so that suture can be removed from conduit.
Step 07
Trocar rotated about 180° (or smaller angles as appropriate for location of suture around port opening) and pushed back inwards to level of markings.
Step 08
Needle reinserted into trocar conduit, through muscle tissue and into abdominal cavity on other side of opening.
Suture grasped by suture carrying needle.
Step 09
Needle withdrawn through tissues and trocar conduit, bringing suture with it to surface.
Step 10
Trocar pulled outwards to reveal lower conduit opening again so that suture can be removed from trocar conduit.
Step 11
Suture safely snugged up around the trocar watched by the intra abdominal telescope. (For multiple individual or continuous sutures, trocar would be kept in until all sutures in place, with each suture tightened and snugged up against sides).
Step 12
Both ends of suture pulled to tighten loop against the peritoneal lining and draw muscle tissue together, maintaining the pneumoperitoneum. Suture site can be inspected with the telescope inside the abdomen. Suture tied against outside of muscle layer.
Notes
Plan view of trocar rotations used to close a port site using three single sutures.
Notes
Muscle tissues drawn together by tying individual sutures after removal of the trocar.
LEGEND
Fat tissue
Muscle tissue
Suturing thread