STUDY COMPARING CARTER-THOMASON DEVICE VERSUS CONVENTIONAL SUTURING IN PORT-SITE CLOSURE

Abstract

NTRODUCTION Technical challenges are common for any surgical interventions, though laparoscopic surgery results in a marked reduction in post-operative pain to patient, with better cosmesis, yet over time comes up the new challenges. One of such challenges are port closing techniques, which are to be dealt meticulously to prevent the trocar site hernias and other complications. AIMS AND OBJECTIVES 1. To document the outcomes of Carter-Thomason device in port closure. 2. To document the outcomes of Conventional suturing in port closure. 3. To compare the efficacy of Carter-Thomason device with Conventional suturing in terms of closure duration, ease of technique, incidence of surgical site infection, post-operative pain and port site hernia. MATERIALS AND METHODS Patients who underwent laparoscopic procedure in General surgery department, R.L Jalappa Hospital, Tamaka, Kolar during December 2019 to June 2021. Choosing subjects: Number of Patients to be studied: 60 Stratified by odd and even method. Patients with similar age, built and co- morbidities are segregated in order to eliminate bias. 4 Odd group(Carter Thomason device): 30 patients Even group (Conventional hand suturing): 30 patients. Inclusion criteria: Patients who are undergoing primary laparoscopic procedure among 19 to 60 years of age group. Port sites greater than 10mm. Exclusion criteria: Patients who already underwent laparoscopic procedures. Immunocompromised individuals (Diabetics, HIV, bleeding disorder, patients on steroid and immunosuppressive therapy) RESULTS Of the port-closure techniques, Carter-Thomason device technique is faster overall, resulted in fewer port-closure-related complications and provided a leak proof closure. Carter-Thomason device closure had better cosmesis compared to conventional port closure group. CONCLUSION The post operative port site pain is noted less with Carter- Thomason device closure compared to conventional suturing . Over all port site closure with carter thomason device is superior and gives best results compared to conventional suturing in terms of time taken for port closure, ease of technique, post operative pain and port site infection.