Access without excess: a comparison of wound infections with disposable versus hybrid trocars in minimally invasive inguinal hernia repairs

@article{woo2026access,
  title = {{Access without excess: a comparison of wound infections with disposable versus hybrid trocars in minimally invasive inguinal hernia repairs}},
  author = {Kimberly P. Woo and Ali Alipouriani and Abby Gross and William C. Bennett and Jenny H. Chang and Alvaro Carvalho and Daphne Remulla and Kayleigh Risser and Nikhila Yerabandi and Li-Ching Huang and Alberto Arezzo and Vittoria Bellato and Myrthe M. Eussen and Maggie Hodges and Sheetal Nijhawan and Marina Yiasemidou and Kimberly S. Miles and Patricia Sylla and Shaneeta M. Johnson and Lucas R. Beffa and Clayton C. Petro and Ajita S. Prabhu and David M. Krpata and Michael J. Rosen and Benjamin T. Miller and SAGES, EAES Sustainability in Surgery Committee},
  journal = {Surgical Endoscopy},
  year = {2026},
  month = oct,
  doi = {10.1007/s00464-026-13408-x},
  url = {https://doi.org/10.1007/s00464-026-13408-x},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Access without excess: a comparison of wound infections with disposable versus hybrid trocars in minimally invasive inguinal hernia repairs
AU  - Kimberly P. Woo
AU  - Ali Alipouriani
AU  - Abby Gross
AU  - William C. Bennett
AU  - Jenny H. Chang
AU  - Alvaro Carvalho
AU  - Daphne Remulla
AU  - Kayleigh Risser
AU  - Nikhila Yerabandi
AU  - Li-Ching Huang
AU  - Alberto Arezzo
AU  - Vittoria Bellato
AU  - Myrthe M. Eussen
AU  - Maggie Hodges
AU  - Sheetal Nijhawan
AU  - Marina Yiasemidou
AU  - Kimberly S. Miles
AU  - Patricia Sylla
AU  - Shaneeta M. Johnson
AU  - Lucas R. Beffa
AU  - Clayton C. Petro
AU  - Ajita S. Prabhu
AU  - David M. Krpata
AU  - Michael J. Rosen
AU  - Benjamin T. Miller
AU  - SAGES, EAES Sustainability in Surgery Committee
PY  - 2026
DA  - 2026/10/06
JO  - Surgical Endoscopy
DO  - 10.1007/s00464-026-13408-x
UR  - https://doi.org/10.1007/s00464-026-13408-x
AB  - Introduction: Operating rooms generate 70% of hospital waste. Transitioning from disposable to reusable devices could mitigate surgical waste. Partially reusable, or hybrid, trocars can be used for minimally invasive surgery (MIS), but perceptions of increased infection risk may drive preferences toward disposable trocars. However, no data substantiates this risk. Our analysis of a national hernia outcomes database investigates this presumed association.  Methods: Using the abdominal core health quality collaborative (ACHQC), we identified high-volume inguinal hernia surgeons who used only disposable trocars for laparoscopic inguinal hernia repair (IHR) and hybrid trocars for robotic IHR. These two surgical approaches served as surrogates to evaluate differences between disposable and hybrid trocars. We performed a query of the ACHQC to identify patients who underwent elective MIS IHR with mesh between 2017 and 2023 by one of the previously identified surgeons.  Results: A total of 34,638 patients met inclusion criteria. After propensity score matching, there were 1191 patients in each group. There was no difference in rates of surgical site infection (SSI), surgical site occurrence requiring procedural intervention (SSOPI), readmission or reoperation between the two groups. There was a statistically significant higher rate of surgical site occurrence (SSO) in the disposable trocar group (5% vs. 2%, p = 0.003). This was driven by a significantly higher rate of hematomas (12% vs 38%, p = 0.007).  Conclusion: This study did not find an increased risk of SSI associated with hybrid trocars compared to disposable trocars for MIS inguinal hernia repairs. To decrease surgical waste, surgeons should consider the use of hybrid trocars for laparoscopic surgery.
SN  - 0930-2794
SN  - 1432-2218
ER  -