Biodegradable Trocar Defect Scaffold Alignment
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Solution Overview
Problem
Current methods for closing trocar site fascial defects during laparoscopic surgery are technically challenging, unreliable, and prone to complications due to the difficulty in visualizing and repairing deep defects, especially in overweight patients, leading to a significant risk of hernia formation and re-operation.
Innovation Solution
A biodegradable device with two offset bases and a connector is used to maintain alignment of the trocar defect edges, allowing initial placement with the trocar in place and completion after its removal, utilizing a scaffold assembly that promotes tissue healing and prevents herniation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional suturing technique is used to close trocar site fascial defect, then the defect can be closed, but the procedure is technically challenging, frustrating, and unreliably successful due to limited skin incision size and blind manipulation
Solution Approach 1:
A closure device is introduced as an intermediary tool between the surgeon and the fascial defect. The device includes a passer that can be inserted through the skin incision to deliver a suture or closure mechanism across the fascial defect, eliminating the need for direct blind manipulation with needles and providing a more reliable and easier closure procedure
Solution Approach 2:
The conventional needle-based mechanical suturing system is replaced with a closure device that may utilize different mechanisms such as absorbable bars, clips, or suture passers. This substitution reduces the technical difficulty and improves reliability by providing better control and visualization during the closure procedure
2Reliability
If deep blind sutures are placed using sharp needles after abdomen decompression, then the fascial defect can be closed, but dangerous complications such as bowel puncture and injury may occur
Solution Approach 1:
The closure device is inserted and positioned through the skin incision before the abdomen is decompressed. This preliminary action allows the surgeon to establish the closure pathway safely while the abdominal contents are still in their normal position, reducing the risk of accidental bowel injury that may occur when placing deep blind sutures after decompression
Solution Approach 2:
The closure device acts as an intermediary that provides a controlled pathway for closing the fascial defect without requiring direct manipulation of sharp needles in the deep abdominal cavity. The device includes features such as tips or guides that can be safely positioned through the skin and into the fascial layer, minimizing the risk of bowel puncture
3Reliability
If needle-dependent closure techniques are used, then the fascial defect can be closed, but the process becomes time-consuming and complicated as more defects need to be closed
Solution Approach 1:
The closure device is divided into separate functional components: a passer or delivery mechanism, a suture or closure element, and a retrieval mechanism. This segmentation allows each component to be optimized for its specific function and enables faster deployment by eliminating the need to thread sutures through needles and manage complex needle-suture assemblies for each defect
Solution Approach 2:
The closure device is designed to handle multiple fascial defects efficiently. The same basic device architecture can be used across different defect sizes and locations, and the device can be configured to address multiple defects in a single procedure, reducing the overall time required compared to using separate needle techniques for each defect
4Object-affected harmful factors
If conventional open repair techniques with dissecting forceps are used, then bowel protection can be achieved, but the technique is impractical and not feasible in tight working spaces
Solution Approach 1:
The closure device includes features such as protective tips, guides, or sheaths that act as intermediaries to protect the bowel from injury during the closure procedure. These features can be positioned through the skin incision and into the fascial layer without requiring the surgeon to manually manipulate bowel-containing structures, making the technique feasible in tight working spaces
Data Source
AI summary
A biodegradable device for maintaining the alignment of the edges of a trocar defect, consisting of two bases coupled and offset by a connector. The first base to be positioned below the defect and a second base above. The first base has a threaded hole from its upper surface but not through the lower surface. The connector attached to the bases such that there is a hole aligned with the threaded hole in the first base allowing a device to mate with the threads in the first base. The second base has a hole aligned with the hole in the connector and wide enough to allow a device to mate with the threads in the first base. The device is arranged so the distance between the lower surface of the second base and upper surface of the first base holds the fascia around the trocar defect.