Patient outcomes and organizational impact of a valve-less trocar insufflation system in laparoscopic surgery: an update of a systematic review.
5 affiliations
- 1CHU Clermont-Ferrand, Service de chirurgie digestive et hépato-bilio-pancréatique, Place Lucie et Raymond Aubrac, Clermont-Ferrand, 63000, France. [email protected].
- 2Direction de la recherche clinique et de l'innovation, Université Clermont Auvergne, INSERM, UMR1107, NEURO-DOL, CHU Clermont-Ferrand, Clermont-Ferrand, F- 63000, France.
- 3Hospices Civils de Lyon, Edouard Herriot Hospital, Service Pharmacie, Lyon, France.
- 4Hospices Civils de Lyon, Documentation Centrale, TAC (Team aux chercheurs), 5 Avenue Esquirol - CS 63752, Lyon Cedex 03, 69424, France.
- 5Université de Lyon, Ecole de pharmacie (ISPB) / UMR CNRS 5510 MATEIS / Hospices Civils de Lyon, Hôpital Edouard Herriot, Service Pharmacie, Lyon, France.
Abstract
Background
A valve-less trocar insufflation system was developed to optimize pneumoperitoneum management during laparoscopic surgery. We updated a systematic review (SR) published in 2020 to evaluate the patient outcomes and organizational impact associated with the use of this system for low-pressure pneumoperitoneum in laparoscopic surgery.Methods
A structured search strategy was employed across multiple electronic databases to identify comparative studies published between April 2020 and June 2025, completing our previous search (January 2010 - April 2020). We were interested in population of patients with various medical conditions who underwent laparoscopic procedures using either the valve-less trocar insufflation system (AIRSEAL® device) or a conventional carbon dioxide insufflator.Results
A total of 21 studies (10 from the previous SR /11 from the updated SR), of which 10 were randomized controlled trials and 11 were non- randomized controlled trials, were selected and enrolled 2,804 patients. Among the 10 studies that evaluated postoperative pain, five reported a significant reduction in shoulder pain and three showed a decrease in general pain- at 24-hour. For analgesic consumption, three out of five studies reported a significant decrease. Of the 18 studies that examined operative duration, 13 did not find a reduction when using AIRSEAL® device. Length of stay was similar across groups. The overall complication rates were comparable between the two insufflators. None of the studies performed a cost-effectiveness or health economic analysis.Conclusion
The systematic review synthesizes the current literature valve-less trocar insufflation systems and largely confirms their feasibility based on patient outcomes, although cost-effectiveness analysis on this system should be encouraged. This work may serve as a valuable basis for future evidence appraisal and the development of clinical practice guidelines.Trial registration
The review protocol of the original systematic review was registered in PROSPERO (CRD42019145665).
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BibTeX
@article{bacoeurouzillou2026patient,
title = {{Patient outcomes and organizational impact of a valve-less trocar insufflation system in laparoscopic surgery: an update of a systematic review.}},
author = {Ophélie Bacoeur-Ouzillou and David Balayssac and Pauline Vaupré and Caroline Giroudon and Xavier Armoiry},
journal = {BMC surgery},
year = {2026},
month = aug,
doi = {10.1186/s12893-026-04095-5},
url = {https://europepmc.org/article/MED/42972336},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Patient outcomes and organizational impact of a valve-less trocar insufflation system in laparoscopic surgery: an update of a systematic review.
AU - Ophélie Bacoeur-Ouzillou
AU - David Balayssac
AU - Pauline Vaupré
AU - Caroline Giroudon
AU - Xavier Armoiry
PY - 2026
DA - 2026/08/06
JO - BMC surgery
DO - 10.1186/s12893-026-04095-5
UR - https://europepmc.org/article/MED/42972336
AB - Background A valve-less trocar insufflation system was developed to optimize pneumoperitoneum management during laparoscopic surgery. We updated a systematic review (SR) published in 2020 to evaluate the patient outcomes and organizational impact associated with the use of this system for low-pressure pneumoperitoneum in laparoscopic surgery.Methods A structured search strategy was employed across multiple electronic databases to identify comparative studies published between April 2020 and June 2025, completing our previous search (January 2010 - April 2020). We were interested in population of patients with various medical conditions who underwent laparoscopic procedures using either the valve-less trocar insufflation system (AIRSEAL® device) or a conventional carbon dioxide insufflator.Results A total of 21 studies (10 from the previous SR /11 from the updated SR), of which 10 were randomized controlled trials and 11 were non- randomized controlled trials, were selected and enrolled 2,804 patients. Among the 10 studies that evaluated postoperative pain, five reported a significant reduction in shoulder pain and three showed a decrease in general pain- at 24-hour. For analgesic consumption, three out of five studies reported a significant decrease. Of the 18 studies that examined operative duration, 13 did not find a reduction when using AIRSEAL® device. Length of stay was similar across groups. The overall complication rates were comparable between the two insufflators. None of the studies performed a cost-effectiveness or health economic analysis.Conclusion The systematic review synthesizes the current literature valve-less trocar insufflation systems and largely confirms their feasibility based on patient outcomes, although cost-effectiveness analysis on this system should be encouraged. This work may serve as a valuable basis for future evidence appraisal and the development of clinical practice guidelines.Trial registration The review protocol of the original systematic review was registered in PROSPERO (CRD42019145665).
SN - 1471-2482
ER -