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There are several types of disposable trocars manufactured for specific medical procedures. Each type has distinct features suitable for varying depths of penetration and tissue types. Below is a breakdown of common types based on these factors.
Optical trocars come with an integrated optic system for direct vision during an operation. This allows surgeons to locate their working area accurately and minimize tissue damage. Often used in laparoscopic cavities, these trocars come with sharp blades for easy penetration.
These trocars are fitted with valves that automatically control gas flow in and out of the abdominal cavity during laparoscopy. This ensures that the correct pressure is always maintained. They also help prevent gas from escaping when instruments are removed.
Spinal trocars come with a cannula and are used primarily in spinal injections or catheter placements. They are designed to give access to the epidural or intrathecal spaces while minimizing tissue damage. Often have a curved shape for better access to the spinal column.
What sets bladeless trocars apart, apart from their name, is that they do not have any blades. Instead, they use an inflatable balloon or cone tip to create an incision. This makes the trocar opening larger but gentler to tissues. This feature is particularly useful for delicate procedures requiring minimal traction on the organs.
A surgeon's choice of a disposable trocar will depend on many factors, including the trocars' key features. Ensuring that these elements are considered will help one stock up on the right disposable trocars for various surgeries.
Trocars are generally made from high-strength plastics or steel alloys. Steel trocars have steel tips and blades for tougher tissues. In contrast, the plastic sharp trocars are designed for less tough tissue and minor surgery. Sometimes, a steel tip is placed on plastic trocars for blended toughness. The tip material is chosen based on how tough the tissue to be penetrated is.
Trocar cannulas, which form the external part surrounding the trocar blade, are often constructed from less tough materials like polycarbonate or PMMA. These softer materials are easier to penetrate and are best for less tough organs like the liver.
The rotation sleeves control how the instruments turn and work. This controls the instruments' movement once inside the body and helps prevent them from tangling. What rotation sleeves are made from varies based on whether rigid or flexible endoscopes are used. Rigid endoscopes require much torque, so the sleeves are produced with tightly meshed geary carbons. In contrast, sleeves for flexible endoscopes are made of soft materials like elastomers.
Optical trocars also have integrated light systems, improving visibility and reducing the need for extra laparoscopic cameras. Insufflation valves help keep internal organs inflated by controlling gas flow and preventing leaks, which helps maintain stable operating conditions.
Electrocaustic trocars have built-in electrical conductivity for tissue cauterization. This helps reduce bleeding. However, it's crucial for other trocars to have good EMI shielding. Failure to do this will result in electromagnetic interference that may affect surgery.
Blades with multiple sharp edges cut tougher tissues more effectively. Sharp blades facilitate smoother cuts and reduce the force needed for penetration. Roughed blade surfaces provide better grip on tissues to avoid slipping as the trocar cuts through.
Other construction materials' features affect how well the disposable trocar works. Therefore, it's good to consider how the products one wants to stock perform.How to choose the disposable trocar
It's important to consider the following factors before settling on the disposable trocar ones' business wants to stock. These, along with the features discussed earlier, will ensure the business stocks ancillaries that hospitals consider essentials.
Different procedures require different types and sizes of trocars. For instance, larger trocars are better suited for complex procedures like organ removal, while smaller ones work well for less invasive surgeries. Bladeless accordion trocars are suitable for delicate surgeries, while sharpened metallic trocars are ideal for tougher tissues.
A hospital's laparoscope system often needs compatible trocars. Such compatibility ensures the system works well together during surgical procedures. Besides, large manufacturers often have the trocars and instruments of the same range. This helps hospitals achieve better operational efficiency. So is obtaining spare parts for broken integrated tools.
When several factors are considered, sometimes, the most logical option is the one that poses the lowest acquisition cost. Ancillaries like trocars that healthcare facilities use in large numbers, highly determine the overall cost of surgery. To minimize this, consider the factors above and prioritize only the most needed products. Unfortunately, don't compromise on quality as this will only result in more damage and greater costs in the long run.
Unlike reusable trocars which require proper maintenance, disposables are just disposed of after one use. However, it's still important to ensure proper disposal. That said below are tips for properly maintaining reusable trocars and some strategies for properly disposing of the disposables.
Storage: Reusable trocars are often constructed with materials that prevent corrosion, such as steel or titanium alloys. While trocars used for open surgery may not need storage, those that go into belly bosoms require careful storage in protective cases to prevent damage to sharp blades and tips. Keeping these in a dry, cool place away from direct sunlight also helps preserve their integrity.
Cleaning: Since most of these are supplied right after being sterilized, cleaning is often overlooked with disposables. Nonetheless, hospitals should sterilize reusable trocars with powerful methods that don't damage them, such as chemical solutions or plasma sterilization. Avoid methods like autoclaving, which may cause damage. After sterilization, inspect each trocar for damage, such as dull blades or bent tips.
Repair: Repairing damaged trocars is usually unfeasible as it wastes time and money. Play saves steel, for instance, can be sharpened by experts with steel grinding tools. However, this sharpening left dent ridges on the trocars and reduces their diameter over time; thus, frequent sharpening is not an ideal solution. Sometimes, a plastic sharpt trocar can be melted with fire and reformed into a new tip; this is not a permanent solution either. Besides, fire weakens materials and renders them less tough. The best repair solution is replacing damaged parts with new ones.
The only practical repair solution for damaged disposable trocars is sometimes welding the blade back onto the shaft. Welding should only be a last resort as it reduces toughness and durability. Moreover, it may lead to infection.
Disposal: It's practically impossible to recycle used disposables. However, hospitals should ensure disposables like trocars are properly disposed of in regulated medical waste environments. This ensures no one is accidentally pricked by needles recovering from discarded sharp items.
Trocars are an important part of the laparoscopic system. By paying close attention to what works well with each system and ensuring proper disposal of used items, hospitals can ensure they have the trocars they need for successful surgical procedures.
A1. Bladed trocars have sharp blades at their ends that cut tissues for penetration. On the other hand, the blade-less trocars have inflatable balloons that create incisions. Bladed trocars cut through tougher tissues more effectively. In contrast, bladeless are suitable for delicate surgeries requiring minimal traction.
A2. It is impossible to recycle hospital disposables like trocars. Trocars play vital roles in laparoscopic surgeries. And these surgeries are minimally invasive procedures carried out while using and frequently exchanging manual instruments within a confined space. It is practically impossible to clean or sterilize used trocars, and that is why they are disposed of after a single use. Moreover, recycling hospital waste is hazardous due to the sharp nature of items like trocars. It is thus virtually impossible to recycle such items correctly.
A3. Consider the purpose for which the trocars will be used. Large trocars are ideal for complex procedures, while smaller ones are suitable for less invasive surgeries. Rural hospitals that go for disposables will want to consider how often they have to carry out laparoscopic surgery. Also, consider the construction materials and their constituents, as explained earlier. Lastly, acquisition costs. The ideal choice will be the one that poses the least cost without compromising quality.
A4. Trocars are minimally hand tools that surgeons use to puncture body cavities. Like other medical tools, trocars do deteriorate over time and require maintenance. When a trocar deteriorates, imagine how painful it must be to have a tool installed up in your body that is no longer sharp, clean, or safe.
As discussed, trocars deal with softer metals that tend to dilapidate faster than harder ones, and age deteriorates any material. Sharpening blunt scalpels, for example, is a meticulous task that should only be done by experts armed with the right tools. Welding previously used blades back onto trocars should also be left to the experts.
