Port-site metastases are not increased by high pressure insufflation

Abstract

Recent case reports of metastasis to laparoscopic trocar wounds suggest that laparoscopic surgery for malignancy could be associated with an increased incidence of wound metastases. Several experimental studies also support this hypothesis. This study sought to determine whether insufflation pressure could influence the development of port-site metastases, following laparoscopic surgery in an established animal model. 7-10 days after implantation of an adenocarcinoma in the left flank, 24 dark Agouti rats underwent laparoscopy with intraperitoneal tumour laceration, under either low (2 mmHg) or high (6 mmHg) insufflation pressure (12 rats in each group). All rats were killed 7 days after the procedure and the wounds examined for the presence of tumour metastasis. Three rats in the low pressure group and five rats in the high pressure group developed port-site tumours (p = 0.67). The number of port-site wounds which developed tumours was the same in both groups (eight per group). The development of laparoscopic port-site metastases is unlikely to be related to the insufflation pressure used during surgery.