Disposable Trocar Sets Vs. Reusable Metal Trocars — How Should Clinicians And Procurement Decide?

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Equipment departments and distributors often face a question during consumables tenders: why have most tertiary hospitals now completely abandoned reusable metal trocars in favor of disposable trocar sets? This shift is driven by three factors: infection control safety, clinical performance, and Total Cost of Ownership (TCO).

Infection Control Dimension:​ Reusable trocars must undergo a full process of pre-cleaning → enzymatic washing → rinsing → drying → sterilization (high temperature or low-temperature plasma). Any oversight in any link can lead to protein residue. Studies indicate that approximately 2%–3% of reprocessed instruments can still detect organic residue. For trocars that directly enter the peritoneal cavity, this risk cannot be ignored. Disposable trocar sets are independently packaged after EO sterilization, are sterile upon opening, and completely eliminate the potential hidden dangers of cross-infection, making them especially suitable for surgeries on patients with hepatitis B, tuberculosis, or multidrug-resistant organisms.

Performance Dimension:​ After dozens of cycles of high-temperature and high-pressure sterilization, the puncture tips of metal trocars inevitably become dull, and sealing valves age and crack. This leads to a need for greater downward pressure during puncture (increasing the risk of accidental deep penetration) and continuous micro-leakage of pneumoperitoneum (affecting the clarity of the surgical field). Every disposable trocar set features a factory-sharp new blade, reducing insertion force by approximately 30%–40%. The silicone dynamic sealing valve is factory-tested to withstand over 500 instrument exchanges without leakage, ensuring more stable pneumoperitoneum maintenance.

Economic Dimension:​ Although the unit price seems higher than reusable instruments, when factoring in reprocessing labor, disinfectant/enzymes, sterilization consumables, damage and loss, traceability management systems, and prolonged surgery time due to instrument failure, the total case cost of single-use sets is often equal to or even lower. More importantly, it simplifies the workload of the CSSD (Central Sterile Supply Department), accelerates operating room turnover, and yields significant benefits in high-volume surgical centers.

Selection Key Points:​ Procurement should focus on: ① Whether it has NMPA Class II/CE certification and complies with YY/T 1710-2020 standards; ② Coverage of specifications 5/10/12/15 mm and different lengths; ③ Type of sealing system (dual seal of duckbill + petal is superior to single seal); ④ Presence of optical transparent obturators and spring sheath safety mechanisms; ⑤ Whether complete set options including Veress needles and specimen retrieval bags are provided for convenient back-to-back surgeries.

In summary: Teaching hospitals, ambulatory surgery centers, and institutions with high volumes of specialized minimally invasive surgeries should prioritize disposable trocar sets. Primary-level institutions that only perform a small number of emergency laparoscopic explorations and have comprehensive reprocessing conditions may保留 (retain) a small number of reusable instruments as backup, but they are not recommended as the mainstay.