Ethicon Endopath Dextrus Minimally Invasive Access System
Pack Sizes Available
Product Description
Technical Specifications
- Entry Method: Visual entry — laparoscope within clear dilating obturator for layer-by-layer visualisation
- Mechanism: Dilating (blunt spreading) entry — no cutting blade; preserves fascial fibre orientation
- Available Port Sizes: 5mm, 12mm, 15mm
- Components: Trocar cannula + dilating obturator + retention device
- Use Type: Single-patient use — sterile, individually packaged
- Compatible Laparoscope: 0-degree rigid laparoscope — placed within obturator for visual entry
Frequently asked questions
Blind trocar insertion uses a pointed or spring-loaded shielded tip to penetrate the anterior abdominal wall without direct visualisation of what lies beneath. Visual entry systems place a laparoscope within the trocar and allow the surgeon to see each layer of the abdominal wall as it is entered, enabling recognition of adhesions, bowel adherent to the peritoneum, or vascular structures before the trocar penetrates them. Major vascular injuries from blind trocar entry are rare but are associated with significant morbidity, and visual entry is advocated by numerous surgical guidelines and professional bodies as a technique to reduce this risk.
A dilating entry mechanism uses a blunt, cone-shaped obturator that pushes through the tissue layers by spreading (dilating) the fibres rather than cutting them. This is in contrast to bladeless cutting trocars (which use a sharp blade) or standard bladed trocars. Dilating entry preserves the structural integrity of the fascial fibres, which is associated with lower bleeding at the port site and lower risk of port-site hernia, as the fascial fibre orientation is maintained rather than being cut. At port removal, the dilated fibres tend to close together, reducing the size of the residual fascial defect.
A 0-degree (straight-viewing) rigid laparoscope is placed within the clear cannula of the Endopath Dextrus obturator for visual entry. The clear plastic obturator tip allows the laparoscope's light and image to pass through and view the tissue ahead of the trocar tip as it enters. A 5mm, 10mm, or specific diameter laparoscope is used depending on the trocar size. The laparoscope should be connected to the camera and light source before beginning the entry so that the video image is available on the monitor as the trocar is advanced.
The Ethicon Endopath Dextrus access system is available in port sizes of 5mm, 12mm, and 15mm. The 5mm port accommodates 5mm laparoscopic instruments, the 12mm port accommodates 12mm linear staplers and other large instruments, and the 15mm port is used for extraction ports in procedures requiring larger specimen removal. The port size selection is determined by the planned instrument passage requirements for the procedure.
Port-site closure after removal of a 12mm or 15mm port is generally recommended to reduce the risk of port-site hernia. A 5mm port does not typically require fascial closure in standard patients. Port-site hernia after 12mm or larger trocar removal is a recognised complication in laparoscopic surgery, with rates reported between 0.2-3% depending on the patient population and technique used. Closure of 12mm and larger fascial defects should be performed at the time of port removal using a suture passer device or direct suture technique.
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