Trocar incisions closure in laparoscopic surgery, using a cyanocrylate’s derivate adhesive. Results in 100 initial cases

Abstract

In 1959 cyanocrylates tissue adhesives were discovered, since that moment has been studied in a multitude of specialties. Because histotoxicity and probably carcinogenicity its use have seen reduced. Interest in better cosmetic results in laparoscopic surgery had been
development new difficult techniques using small instruments, less than 5mm, in order to improve scar results. Objective: The purpose of this study was to evaluate improvements in scar results in laparoscopic surgery using a cyanocrylates adhesive. Patients and method: We decided to run a prospective study using an octyl cyanocrylates tissue adhesive, (Dermabond). In 100 consecutive patients who went to different laparoscopic procedures we used tissue adhesive to close trocars incisions. We closed 374 incisions with tissue adhesive. To evaluate octyl-cyanocrylate adhesive we designed a data chart that included dehiscence, toxicity, advantages, disadvantage, patient acceptance and
cosmetic improvement. Pictures were taken immediately after surgery; 24 hrs; 7 days; 3 weeks; and 6 weeks post op. Results: A 57% of patients were female. Age range was 18 to 63, mean: 35. Laparoscopic procedures include laparoscopic cholecystectomy 52%; appendectomy 23%; gynecological 12%, Nissen procedure 5%, and other laparoscopic procedures 8%. No dehiscence was present in 95.7%; partial dehiscence 1,6% (6 scars). No toxicity was observed. Advantages: easy use, no pain, no additional dressing was used. Disadvantage: carefully hemos-tasis, to prevent clot accumulation under it layer. Patient’s acceptance was 100%. Conclusions: This is probably a small group of patients, but we found better cosmetic results using octyl-cyanocrylate tissue adhesive (Dermabond®).