Port-site recurrence reproduced in the VX-2 rabbit carcinoma model: an in vivo model comparing laparoscopic port sites and open incisions.

N. W. Wilkinson, A. J. Shapiro, S. B. Harvey, R. S. Stack, R. L. Cornum

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: The use of advanced laparoscopy remains controversial in the field of surgical oncology because the potential for port-site recurrence may violate sound oncologic principles. Two mechanisms are theorized to be the cause of port-site recurrences: first, indirect contamination caused by pneumoperitoneum, aerosolization, or intraperitoneal spread, and second, direct contamination by physical trocar seeding. METHODS: A VX-2 carcinoma cell suspension was transferred under the left renal capsule of 31 rabbits with either an open flank incision (16) or laparoscopy (15). Animals were observed for tumor recurrence at the video port, the working port, and the open incision. Intraoperative findings and necropsy were used to document recurrence. RESULTS: The open incision technique resulted in local tumor recurrence in 1/16 animals with 16/16 viable intraabdominal tumors. The laparoscopic technique resulted in 0/15 video port-site recurrences and 9/15 working port-site recurrences, with 14/15 viable intraabdominal tumors. Recurrence at the laparoscopic working port occurred more frequently than in the open (P < 0.02) or laparoscopic video port groups (P < 0.007). No significant difference existed in recurrence between the open incision and the laparoscopic video port (P > 0.5). CONCLUSIONS: Laparoscopic port-site recurrences can be reproduced using the transplantable VX-2 rabbit carcinoma model. In the VX-2 model, trocar recurrence is the result of direct contamination via surgical instrumentation of viable tumor cells. The effect of the pneumoperitoneum or intraperitoneal cytological spillage (indirect contamination) does not have any effect on trocar recurrence. This model can be used to test and improve laparoscopic techniques to minimize the risk of port-site recurrence. Until technological advances have eliminated the risk of trocar recurrences, direct contact between malignant cells and laparoscopic instruments should be performed with caution.

Original languageEnglish
Pages (from-to)221-226
Number of pages6
JournalJSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
Volume5
Issue number3
StatePublished - Jan 1 2001
Externally publishedYes

Fingerprint

Rabbits
Carcinoma
Recurrence
Surgical Instruments
Pneumoperitoneum
Neoplasms
VX
Laparoscopy
Capsules
Suspensions
Kidney

Cite this

Port-site recurrence reproduced in the VX-2 rabbit carcinoma model : an in vivo model comparing laparoscopic port sites and open incisions. / Wilkinson, N. W.; Shapiro, A. J.; Harvey, S. B.; Stack, R. S.; Cornum, R. L.

In: JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons, Vol. 5, No. 3, 01.01.2001, p. 221-226.

Research output: Contribution to journalArticle

@article{c5bcfc45623b436cb7886edec932a24d,
title = "Port-site recurrence reproduced in the VX-2 rabbit carcinoma model: an in vivo model comparing laparoscopic port sites and open incisions.",
abstract = "BACKGROUND: The use of advanced laparoscopy remains controversial in the field of surgical oncology because the potential for port-site recurrence may violate sound oncologic principles. Two mechanisms are theorized to be the cause of port-site recurrences: first, indirect contamination caused by pneumoperitoneum, aerosolization, or intraperitoneal spread, and second, direct contamination by physical trocar seeding. METHODS: A VX-2 carcinoma cell suspension was transferred under the left renal capsule of 31 rabbits with either an open flank incision (16) or laparoscopy (15). Animals were observed for tumor recurrence at the video port, the working port, and the open incision. Intraoperative findings and necropsy were used to document recurrence. RESULTS: The open incision technique resulted in local tumor recurrence in 1/16 animals with 16/16 viable intraabdominal tumors. The laparoscopic technique resulted in 0/15 video port-site recurrences and 9/15 working port-site recurrences, with 14/15 viable intraabdominal tumors. Recurrence at the laparoscopic working port occurred more frequently than in the open (P < 0.02) or laparoscopic video port groups (P < 0.007). No significant difference existed in recurrence between the open incision and the laparoscopic video port (P > 0.5). CONCLUSIONS: Laparoscopic port-site recurrences can be reproduced using the transplantable VX-2 rabbit carcinoma model. In the VX-2 model, trocar recurrence is the result of direct contamination via surgical instrumentation of viable tumor cells. The effect of the pneumoperitoneum or intraperitoneal cytological spillage (indirect contamination) does not have any effect on trocar recurrence. This model can be used to test and improve laparoscopic techniques to minimize the risk of port-site recurrence. Until technological advances have eliminated the risk of trocar recurrences, direct contact between malignant cells and laparoscopic instruments should be performed with caution.",
author = "Wilkinson, {N. W.} and Shapiro, {A. J.} and Harvey, {S. B.} and Stack, {R. S.} and Cornum, {R. L.}",
year = "2001",
month = "1",
day = "1",
language = "English",
volume = "5",
pages = "221--226",
journal = "Journal of the Society of Laparoendoscopic Surgeons",
issn = "1086-8089",
publisher = "Society of Laparoendoscopic Surgeons",
number = "3",

}

TY - JOUR

T1 - Port-site recurrence reproduced in the VX-2 rabbit carcinoma model

T2 - an in vivo model comparing laparoscopic port sites and open incisions.

AU - Wilkinson, N. W.

AU - Shapiro, A. J.

AU - Harvey, S. B.

AU - Stack, R. S.

AU - Cornum, R. L.

PY - 2001/1/1

Y1 - 2001/1/1

N2 - BACKGROUND: The use of advanced laparoscopy remains controversial in the field of surgical oncology because the potential for port-site recurrence may violate sound oncologic principles. Two mechanisms are theorized to be the cause of port-site recurrences: first, indirect contamination caused by pneumoperitoneum, aerosolization, or intraperitoneal spread, and second, direct contamination by physical trocar seeding. METHODS: A VX-2 carcinoma cell suspension was transferred under the left renal capsule of 31 rabbits with either an open flank incision (16) or laparoscopy (15). Animals were observed for tumor recurrence at the video port, the working port, and the open incision. Intraoperative findings and necropsy were used to document recurrence. RESULTS: The open incision technique resulted in local tumor recurrence in 1/16 animals with 16/16 viable intraabdominal tumors. The laparoscopic technique resulted in 0/15 video port-site recurrences and 9/15 working port-site recurrences, with 14/15 viable intraabdominal tumors. Recurrence at the laparoscopic working port occurred more frequently than in the open (P < 0.02) or laparoscopic video port groups (P < 0.007). No significant difference existed in recurrence between the open incision and the laparoscopic video port (P > 0.5). CONCLUSIONS: Laparoscopic port-site recurrences can be reproduced using the transplantable VX-2 rabbit carcinoma model. In the VX-2 model, trocar recurrence is the result of direct contamination via surgical instrumentation of viable tumor cells. The effect of the pneumoperitoneum or intraperitoneal cytological spillage (indirect contamination) does not have any effect on trocar recurrence. This model can be used to test and improve laparoscopic techniques to minimize the risk of port-site recurrence. Until technological advances have eliminated the risk of trocar recurrences, direct contact between malignant cells and laparoscopic instruments should be performed with caution.

AB - BACKGROUND: The use of advanced laparoscopy remains controversial in the field of surgical oncology because the potential for port-site recurrence may violate sound oncologic principles. Two mechanisms are theorized to be the cause of port-site recurrences: first, indirect contamination caused by pneumoperitoneum, aerosolization, or intraperitoneal spread, and second, direct contamination by physical trocar seeding. METHODS: A VX-2 carcinoma cell suspension was transferred under the left renal capsule of 31 rabbits with either an open flank incision (16) or laparoscopy (15). Animals were observed for tumor recurrence at the video port, the working port, and the open incision. Intraoperative findings and necropsy were used to document recurrence. RESULTS: The open incision technique resulted in local tumor recurrence in 1/16 animals with 16/16 viable intraabdominal tumors. The laparoscopic technique resulted in 0/15 video port-site recurrences and 9/15 working port-site recurrences, with 14/15 viable intraabdominal tumors. Recurrence at the laparoscopic working port occurred more frequently than in the open (P < 0.02) or laparoscopic video port groups (P < 0.007). No significant difference existed in recurrence between the open incision and the laparoscopic video port (P > 0.5). CONCLUSIONS: Laparoscopic port-site recurrences can be reproduced using the transplantable VX-2 rabbit carcinoma model. In the VX-2 model, trocar recurrence is the result of direct contamination via surgical instrumentation of viable tumor cells. The effect of the pneumoperitoneum or intraperitoneal cytological spillage (indirect contamination) does not have any effect on trocar recurrence. This model can be used to test and improve laparoscopic techniques to minimize the risk of port-site recurrence. Until technological advances have eliminated the risk of trocar recurrences, direct contact between malignant cells and laparoscopic instruments should be performed with caution.

UR - http://www.scopus.com/inward/record.url?scp=0035406593&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035406593&partnerID=8YFLogxK

M3 - Article

C2 - 11548826

AN - SCOPUS:0035406593

VL - 5

SP - 221

EP - 226

JO - Journal of the Society of Laparoendoscopic Surgeons

JF - Journal of the Society of Laparoendoscopic Surgeons

SN - 1086-8089

IS - 3

ER -