The addition of a Rumel suture minimizes entry portal gas leakage of laparoscopic ports: a canine cadaveric study.

OBJECTIVE

To compare periportal gas leakage of 3 laparoscopic cannulas with and without a Rumel suture.

METHODS

This was a descriptive canine cadaveric (n = 10) study performed from October 28 to 29, 2023. Five portal configurations were compared: a smooth (S) and threaded (T) cannula with and without a Rumel suture (SR and TR, respectively) and a balloon (B) cannula. Each configuration was inserted once each on midline and paramedian, the abdomen was insufflated to 10 mm Hg, and the cannula was manipulated for 2 minutes. Gas leakage was recorded by using a soap bubble test and the duration of insufflation (seconds).

RESULTS

Regardless of location, SR and TR had the fewest number of leaks and duration of insufflation. When comparing midline portal locations, there were no demonstrable differences in duration of insufflation between portal configurations. When comparing the estimated difference in duration of insufflation for paramedian portal locations, SR had a lower duration of insufflation compared to T by 67.0 seconds and S by 46.2 seconds, and TR had a lower duration of insufflation compared to T by 66.5 seconds and S by 45.7 seconds. Between midline and paramedian, the S configuration had a statistically significant decrease in duration of insufflation on midline compared to paramedian by 30.4 seconds. The T configuration had a significantly lower duration of insufflation on midline compared to paramedian by 51.1 seconds.

CONCLUSIONS

Gas leakage varies between portals, and adding a Rumel suture decreased gas leakage.

CLINICAL RELEVANCE: Surrounding stainless steel entry portals with a Rumel suture could help minimize insufflation leakage of the cannula.