Editorial comment on Carter-Thomason subcutaneous tissue closure device for laparoscopic procedure
Nezhat C et al.Minim Invasive Ther Allied Technol 1996;5:495.
Sir – We read with interest the paper of Drs. Airan and Sandor regarding a new device for laparoscopic incisional repair. In this article, the authors have stated that the Carter-Thomason device sometimes causes ilio-inguinal nerve entrapment and subsequent lower abdominal pain. We have been using this device routinely for the past few years for closure of different sizes of laparoscopic incisions in different patient populations without any problems or such complications. We do not agree with the authors that the angle of entry cannot be changed using this device. Different available sizes of the Carter-Thomason obturator allow the surgeon to select the appropriate size based on the patient's weight and the size of the incision ( 5mm, 10mm or larger). An instrument is as safe as the surgeon who is using it.
Ilio-inguinal nerve entrapment or other complications such as abdominal and lateral pelvic wall vessel injury can occur with any of the available incisional closure devices. Control of entry and appropriate angle of insertion are the key factors in using these devices successfully.
