Hybrid reusable trocars show no excess infection in hernia repair

Design

Propensity-matched registry cohort

Population

2,382 elective minimally invasive inguinal hernia repairs with mesh

Primary outcome

Surgical-site infection

Effect

No difference in infection; surgical-site occurrence 2% vs 5%

Using the US Abdominal Core Health Quality Collaborative registry, researchers compared high-volume surgeons who used only disposable trocars (laparoscopic inguinal hernia repair) with those who used partly reusable hybrid trocars (robotic repair), 2017 to 2023. After propensity matching there were 1,191 patients in each group.

Surgical-site infection, interventions for wound events, readmission and reoperation did not differ. Overall surgical-site occurrences were less frequent in the hybrid group (2% vs 5%).

Trocar type was tied to operative approach, so this compares laparoscopic and robotic repair as much as it compares trocars. Still, it removes the main argument against reusable ports. For Indian units, where reprocessing is common and disposable cost matters, it is reassuring rather than new.

• Consider hybrid or reusable trocars where reprocessing is reliable; infection rates were similar.
• Keep sterile reprocessing audited; the result assumes it is done properly.
• Include device waste and cost in theatre procurement decisions.
• Track your own wound infection rate after any change of trocar system.

Why it matters

Infection fear is the usual reason given for single-use ports, and these data do not support it.

The statistics, in plain English

Propensity matching makes the two groups similar on measured factors, but cannot balance the surgical approach itself, which differed by design.

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