Trocar
A trocar (or trochar) is a
Etymology
The word trocar, less commonly trochar,[3] comes from French trocart or trocar, itself either from trois-quarts 'three fourths' or from trois carres 'three sides';[4][5][6] in any case referring to the instrument's triangular point. First recorded in the Dictionnaire des Arts et des Sciences, 1694,[7] by Thomas Corneille, younger brother of Pierre Corneille.
History
Originally, doctors used trocars to relieve pressure build-up of fluids (edema) or gases (bloating). Patents for trocars appeared early in the 19th century, although their use dated back possibly thousands of years. By the middle of the 19th century, trocar-cannulas had become sophisticated, such as Reginald Southey's invention of the Southey tube.[8]
Applications
Medical/surgical use
Trocars are used in medicine to access and drain collections of fluid such as in a patient with hydrothorax or ascites.
In modern times, surgical trocars are used to perform laparoscopic surgery. They are deployed as a means of introduction for cameras and laparoscopic hand instruments, such as scissors, graspers, etc., to perform surgery hitherto carried out by making a large abdominal incision, something that has revolutionized patient care. Today, surgical trocars are most commonly a single patient use instrument and have graduated from the "three-point" design that gave them their name to either a flat bladed "dilating-tip" product or something that is entirely blade free. This latter design offers greater patient safety due to the technique used to insert them.
Trocar insertion can lead to a perforating puncture wound of an underlying organ resulting in a
Embalming
Trocars are also used near the end of the
After cavity embalming has been finished, the puncture is commonly sealed using a small plastic object resembling a screw, called a trocar button.
Veterinary use
Trocars are widely used by veterinarians not only for draining hydrothorax, ascites, or for introducing instruments in laparoscopic surgery, but for acute animal-specific conditions as well. In cases of ruminal tympany in cattle, a wide-bore trocar may be passed through the skin into the rumen to release trapped gas.[10] In dogs, a similar procedure is often performed for patients presenting with gastric dilatation volvulus in which a wide-bore trocar is passed through the skin into the stomach to immediately decompress the stomach. Depending on the severity of clinical signs on presentation, this is often performed after pain management has been administered but prior to general anaesthesia. Definitive surgical treatment involves anatomical repositioning of the stomach and spleen followed by a right-sided gastropexy.[11] Depending on the severity, partial gastrectomy and/or splenectomy may be indicated if the relevant tissues have necrosed due to ischemia caused by torsion/avulsion of the supplying vasculature.
In popular culture
In the movie Far from the Madding Crowd (1967) Gabriel Oak, played by Alan Bates, uses a trocar to aspirate abdominal gasses from Bathsheba Everdene's herd of sheep who had strayed into a field of clover and were bloated.
In the movie True Lies, Arnold Schwarzenegger's character, having picked the lock on his handcuffs, uses a Patterson trocar to kill his guard prior to breaking the neck of his torturer.
Citations
- ^ Equipment and instrumentation for Laparoscopic bariatric surgery in Cleveland Clinic
- ^ Alph Degive, Précis de médicine opératoire vétérinaire, Asselin & Houzeau, 1908, p. 139
- ^ "trocar". Merriam-Webster Dictionary. Merriam-Webster. Retrieved December 6, 2018.
- ^ "trocar". Oxford Dictionaries. Oxford University Press. Archived from the original on December 6, 2018. Retrieved December 6, 2018.
- ISBN 978-1-4398-1189-4. Retrieved December 6, 2018.
- ^ Diderot, Denis (1751). L'Encyclopédie.
- ^ "Dictionnaire des Arts et des Sciences - Wikisource". fr.wikisource.org.
- ^ Library, Boston Medical (20 February 2018). "Boston Medical Library". www.countway.harvard.edu.
- PMID 22442503.)
{{cite journal}}
: CS1 maint: DOI inactive as of April 2024 (link - ISBN 978-0-7020-7058-7.
- ^ Bright, Ronald M. (June 2007). "Acute Gastric Dilatation-Volvulus in Dogs" (PDF). Clinician's Brief. Archived from the original (PDF) on 2018-02-19. Retrieved 2017-08-04.
General and cited references
- Janet Amundson Romich. An illustrated guide to veterinary medical terminology, Volume 1
- Mayer, Robert (2006). Embalming: History, Theory, and Practice (4th ed.). McGraw-Hill. ISBN 0-07-143950-1.