Article

Surgical Endoscopy And Other Interventional Techniques

, Volume 19, Issue 12, pp 1636-1640

First online:

Pneumoperitoneum does not influence trocar site implantation during tumor manipulation in a solid tumor model

  • V. J. HalpinAffiliated withDepartment of Surgery, Washington University School of Medicine Email author 
  • , R. A. UnderwoodAffiliated withDepartment of Surgery, Washington University School of Medicine
  • , D. YeAffiliated withDepartment of Surgery, Washington University School of Medicine
  • , D. H. CooperAffiliated withDepartment of Surgery, Washington University School of Medicine
  • , M. WrightAffiliated withDepartment of Surgery, Washington University School of Medicine
  • , S. M. HickersonAffiliated withDepartment of Surgery, Washington University School of Medicine
  • , W. C. ConnettAffiliated withDepartment of Surgery, Washington University School of Medicine
  • , J. M. ConnettAffiliated withDepartment of Surgery, Washington University School of Medicine
  • , J. W. FleshmanAffiliated withDepartment of Surgery, Washington University School of Medicine

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Abstract

Background

The purpose of this study was to assess tumor implantation at abdominal wound sites following manipulation of a solid abdominal tumor.

Methods

GW-39 human colon cancer cells were injected into the omentum of golden Syrian hamsters. At 2 weeks, an omental tumor was harvested and animals were randomized to bivalve (A), crush (B), strip (C), or excision (D), with or without pneumoperitoneum. Four 5-mm trocars were inserted into the abdomen, and the tumor was reinserted through the midline, swept through four quadrants, and removed. The incision was closed and pneumoperitoneum at 7 mmHg was maintained for 10 min. Tumor implantation at wound sites was documented at 7 weeks.

Results

Implantation at trocar sites was 53 and 49% with and without pneumoperitoneum in the manipulated groups (A, B, C), respectively (p = 0.993). Implantation at trocar sites was reduced in the control group (D) at 9 and 10% with and without pneumoperitoneum, respectively (p < 0.001).

Conclusions

Tumor implantation at trocar sites is due to spillage of tumor during manipulation and not to pneumoperitoneum.

Keywords

Colon cancer Laparoscopy Pneumoperitoneum Surgical technique Metastases