A Randomized, Prospective Study Comparing the Use of the Missile Trocar and the Pyramidal Trocar for Laparoscopy Access
Tanvaa Tansatit MD, MSc*, Wirach Wisawasukmongchol MD**, Suvit Bunyavejchevin MD**
Affiliation : * Department of Anatomy, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University ** Department of Obstetrics and Gynecology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University
Background : The missile trocar was developed for smooth abdominal penetration of the primary port. It
contains a longitudinal tunnel connecting the abdominal cavity with the outside.
Objective : To evaluate the efficacy of the missile trocar compared with the traditional method using the Veress
needle.
Materials and Methods : The times required to enter the abdominal cavity and the difficulty of the procedure
were compared with the traditional Veress needle. A blind technique was used on 100 consecutive patients in
a randomized fashion.
Results : The missile trocar technique took 2.7 + 1.6 minutes to perform compared with 3.9 + 1.3 min in the
Veress needle group (p = 0.001), and the difficulty of the procedure was 2.1 + 1.9 cm (p = 0.433) rated from
10-cm scale. No carbon dioxide leakage or serious complications occurred in any patient.
Conclusion : The results of the present study indicate that a long-tip missile trocar technique may be used
safely when the technique is fully understood. This procedure is a relatively quick alternative approach for
laparoscopy.
Keywords : Missile trocar, Primary port, Laparoscopy, Randomized trial
