Pneumoperitoneum Does Not Influence Trocar Site Implantation During Tumor Manipulation in a Solid Tumor Model

Background: The purpose of this study was to assess tumor implantation at abdominal wound sites following manipulation of a solid abdominal tumor.

Methods: GW-39 human colon cancer cells were injected into the omentum of golden Syrian hamsters. At 2 weeks, an omental tumor was harvested and animals were randomized to bivalve (A), crush (B), strip (C), or excision (D), with or without pneumoperitoneum. Four 5-mm trocars were inserted into the abdomen, and the tumor was reinserted through the midline, swept through four quadrants, and removed. The incision was closed and pneumoperitoneum at 7 mmHg was maintained for 10 min. Tumor implantation at wound sites was documented at 7 weeks.

Results: Implantation at trocar sites was 53 and 49% with and without pneumoperitoneum in the manipulated groups (A, B, C), respectively (p = 0.993). Implantation at trocar sites was reduced in the control group (D) at 9 and 10% with and without pneumoperitoneum, respectively (p < 0.001).

Conclusions: Tumor implantation at trocar sites is due to spillage of tumor during manipulation and not to pneumoperitoneum.