A NOVEL LAPAROSCOPIC PORT CLOSURE NEEDLE VERSUS THE CONVENTIONAL SUTURE PASSER FOR TROCAR-SITE FASCIAL CLOSURE: A PROSPECTIVE COMPARATIVE STUDY

Abstract

Background: Trocar defects of 10 mm or larger must be securely approximated, or they can progress to port-site hernia and other wound-related morbidity. Standard suture-passer instruments frequently need several attempts to capture the fascia and leave the operating surgeon fatigued, an effect that is magnified in patients with a thick abdominal wall. We therefore assessed a newly engineered, reusable needle built specifically to make trocar-site closure more straightforward. Methods: Thirty adults scheduled for elective laparoscopic cholecystectomy, appendicectomy, TAPP repair or IPOM repair, each requiring closure of at least one 10-mm or larger port, took part in this prospective, interventional, two-arm comparison. Fifteen patients had their trocar sites closed with the newly developed needle and fifteen with a standard suture passer. Time taken to close the port served as the primary endpoint; secondary endpoints comprised surgeon-reported ease of handling and fatigue on a 10-point visual analogue scale, complications occurring during surgery, pain scored at 24 hours after surgery, and wound-related problems tracked for three months afterward. Group differences for numerical data were tested with an unpaired t-test, while proportions were compared using chi-square analysis or Fisher's exact test as appropriate (SPSS version 26.0); a p-value below 0.05 was taken to indicate significance. Results: The two groups did not differ on any baseline demographic or clinical variable (p>0.05 throughout). Closure of the port took considerably less time with the new instrument, averaging 1.68±0.18 minutes against 3.49±0.31 minutes for the conventional passer (p<0.001). Surgeons also rated the novel needle easier to handle (score 9.27±0.24 versus 7.21±0.24; p<0.001) and reported markedly less fatigue while using it (2.05±0.25 versus 4.50±0.24; p<0.001); pain scores 24 hours after surgery were likewise lower in the novel-needle arm (2.33±0.49 versus 3.47±0.52; p<0.001). Complications occurring either during or after the operation — for instance instrument breakage (0% versus 13.3%) and port-site hernia (0% versus 6.7%) — trended lower with the new device, although none of these differences reached statistical significance. Conclusion: Compared with the conventional suture passer, the newly designed needle closed fascial defects more quickly, was easier to operate, and produced less surgeon fatigue, while its safety profile remained similar. These early results justify continued refinement of the prototype and testing in larger trials spanning multiple centres.