Ob-Gyn News 31(11) June 1, 1996 Clinical Outcomes
RADIALLY EXPANDABLE ACCESS DEVICE CUTS BLEEDING
The radially expandable access system (Step™) leads to significantly less abdominal bleeding
than conventional trocars .
The Step device, unlike a trocar which cuts through tissue, uses a blunt dilator to expand the
tissue tract formed by the Veress needle. The study reported on 6 laparoscopic surgeries:
LAVH, LAVH with bilateral salpingo-oophorectomy, LAVH with dilation and curettage,
fulguration, adhesiolysis, and inguinal hernia repair. 136 Step and 255 conventional trocars
were inserted in 115 women and 15 men. Abdominal wall bleeding was significantly less with
the Step device (0% vs. 3%). Fascial defects left by 10-mm Step cannulas average 5 mm and are
not closed. Mean operating room times were less
(76 min, Step; 101 min, trocar), which contributed to decreased costs. The average savings
across all procedure groups was $345 to $515 per patient.
The Step radially expanding access device leads to significantly less abdominal bleeding, lower
procedure times, smaller fascial defects, and procedural cost savings.
*Abstract adapted from original paper/presentation.