TY - JOUR
T1 - Does the Difference in Fascial Closure Technique Affect Postoperative Pain?
AU - Lyapis, Anna
AU - Ulrich, Amanda
AU - LaMonica, Rachel
AU - Kuo, Chia Ling
AU - Kaye, Leah
AU - Luciano, Danielle
N1 - Publisher Copyright:
© 2017 American Association of Gynecologic Laparoscopists
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Study Objective: To compare postoperative incisional pain on postoperative days (PODs) 1 and 14 when using a fascial closure device (FCD) versus a traditional fascial closure (TFC) of the 12-mm upper quadrant port during robotic surgery. Time required to close the incision was also compared. Design: Randomized controlled trial (Canadian Task Force classification I). Setting: Two academic affiliated hospitals, The Hospital of Central Connecticut and The University of Connecticut. Patients: Women undergoing robotic surgery for benign indications by minimally invasive gynecologists at our institutions between November 2012 and October 2014 were enrolled in the study at their preoperative visit. Interventions: Patients were randomized to either an FCD or TFC immediately before closure of the fascial incision. Pain score using a 10-point analog pain scale was recorded on POD 1 and POD 14. Time to close the fascial incision, length of surgery, and body mass index were also recorded. Measurements and Main Results: Sixty-seven patients were enrolled, and 65 were randomized at the time of the fascial closure, whereas 2 enrolled patients converted to laparotomy. Statistical analysis demonstrated that pain scores differed by fascial closure technique. Mean pain scores on POD 1 were 3.43 ± 2.48 and 2.06 ± 2.03 for the FCD and TFC, respectively (p =.028). On POD 14 the mean pain scores were 1.97 ± 2.48 and.83 ± 1.42 for the FCD and TFC, respectively (p =.102). Times to close fascia were 106.5 ± 102.28 seconds and 141.97 ± 102.85 seconds for the FCD and TFC, respectively (p =.138). Conclusion: Our study demonstrates that at POD 1 the use of the fascia closure device results in higher pain scores without a significant difference in closure time.
AB - Study Objective: To compare postoperative incisional pain on postoperative days (PODs) 1 and 14 when using a fascial closure device (FCD) versus a traditional fascial closure (TFC) of the 12-mm upper quadrant port during robotic surgery. Time required to close the incision was also compared. Design: Randomized controlled trial (Canadian Task Force classification I). Setting: Two academic affiliated hospitals, The Hospital of Central Connecticut and The University of Connecticut. Patients: Women undergoing robotic surgery for benign indications by minimally invasive gynecologists at our institutions between November 2012 and October 2014 were enrolled in the study at their preoperative visit. Interventions: Patients were randomized to either an FCD or TFC immediately before closure of the fascial incision. Pain score using a 10-point analog pain scale was recorded on POD 1 and POD 14. Time to close the fascial incision, length of surgery, and body mass index were also recorded. Measurements and Main Results: Sixty-seven patients were enrolled, and 65 were randomized at the time of the fascial closure, whereas 2 enrolled patients converted to laparotomy. Statistical analysis demonstrated that pain scores differed by fascial closure technique. Mean pain scores on POD 1 were 3.43 ± 2.48 and 2.06 ± 2.03 for the FCD and TFC, respectively (p =.028). On POD 14 the mean pain scores were 1.97 ± 2.48 and.83 ± 1.42 for the FCD and TFC, respectively (p =.102). Times to close fascia were 106.5 ± 102.28 seconds and 141.97 ± 102.85 seconds for the FCD and TFC, respectively (p =.138). Conclusion: Our study demonstrates that at POD 1 the use of the fascia closure device results in higher pain scores without a significant difference in closure time.
KW - Fascial closure device
KW - Postoperative pain
KW - Robotic surgery
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U2 - 10.1016/j.jmig.2017.07.020
DO - 10.1016/j.jmig.2017.07.020
M3 - Article
C2 - 28757438
AN - SCOPUS:85028620793
SN - 1553-4650
VL - 24
SP - 1190
EP - 1194
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
IS - 7
ER -