BACKGROUND: Understanding abdominal wall thickness (AWT) is a key to optimal trocar design and enhancing surgical workspace layout, with a view to developing low profile laparoscopic ports, reducing clutter, and improving operative workflow. In order to establish a knowledge base upon which design can build, we measured AWT at the point of trocar insertion. METHODS: During consecutive laparoscopic procedures, AWT was measured at the location of trocar placement under 12-15 mmHg of insufflation. Immediately prior to removal of each trocar, the trocar tip was retracted until flush with the inner abdominal wall and the trocar shaft then marked at skin surface. Thickness was defined as the distance from the tip to surface marking. Trocar location was recorded. RESULTS: Data from 30 patients (mean age=52, SD=16, range=18-77) with BMI average 29 (SD=5.7, range=20-45) are reported below. Correlation between BMI and AWT was generally was strong. Wall thickness correlation varied according to the particular region of the abdomen. The RUQ showed the strongest relation, while the umbilical region showed no significant correlation. CONCLUSIONS: BMI correlates to AWT, although regional differences were noted. It may be possible to optimize port designs or dimensions for specific abdominal regions. The data presented here may be useful in providing a foundation for the design of trocars and instruments as greater attention is paid to human factors and ergonomic issues.
Program Number: P382