Abstract
Background: The last procedure of the surgeon in laparoscopic surgery is to extract the specimen with the smallest incision. This experiment aimed to explore the maximum diameter of specimens that can be extracted with different adjuvant incision length and shape by in vitro physical experiments.Materials and Methods: We use the abdominal wall with the muscle layer of pigs was fixed on a square wooden frame to simulate the abdominal wall of humans. Then, making specimen extraction port: circular, inverted Y-shaped and straight-line incisions with different sizes and lengths respectively,and making different sizes and species specimens. These specimens are extracted from different incisions by force device. Measure the tension value (N), and record the length or diameter of the smallest auxiliary incision that the largest sample diameter can pass through. This experiment provides us with preliminary experience on how to choose the appropriate specimen extraction auxiliary incision according to the specimen diameter in surgery. Results: The maximum diameters of specimens that can be extracted with circular ostomy diameters of 2.4, 2.7 and 3.3 cm are 4.0, 4.5 and 6.0 cm, respectively. Specimens with diameters of 6.0, 8.0 and 10.0 cm could be extracted with inverted Y-shaped incisions with the length around umbilicus of 1 cm and extension length of 1.0, 3.0, 4.0 cm, respectively. Moreover, these same specimens could be extracted with inverted Y-shaped incisions with the length around umbilicus of 2 cm and extension length of 0.0, 1.0 and 2.0 cm, respectively. In straight-line incisions, tough tissue specimens (made from chicken gizzard) with diameters of 1.0, 2.0, 4.0 and 6.0 cm could be removed from incisions with diameters of 1.0, 2.0, 3.0 and 4.0 cm, respectively. Conclusion: Along with preoperative imaging, surgical planning and trocar position, the shape and length of adjuvant incisions can be used to improve the extraction of specimens via laparoscopy.