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The application scope of needle-type trocars has long expanded beyond initial laparoscopic use, extending broadly to surgery, gastroenterology, orthopedics, gynecology and multiple other disciplines. These devices open up minimally invasive access pathways into the human body, transforming numerous traditional open surgeries into "keyhole procedures" performed through tiny incisions.

I. Laparoscopic Surgery: The Most Classic Core Application

Laparoscopic operations represent the best-known scenario for needle-type trocars. For cholecystectomy, appendectomy, hernia repair, bariatric sleeve gastrectomy and other procedures, surgeons first make a small periumbilical incision and insert a primary trocar (typically 10–12 mm). After establishing pneumoperitoneum, the laparoscope is introduced. Under direct visualization, secondary 5 mm or 10 mm trocars are placed at additional abdominal sites as working ports for surgical instruments. The sharp penetration performance and reliable airtight sealing of needle-type trocars sustain stable pneumoperitoneum, an essential prerequisite for smooth surgery.

II. Endoscopic and Gastrointestinal Interventions

In endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), needle-type trocars act as submucosal injection needles. They deliver saline or sodium hyaluronate beneath lesions to elevate abnormal tissue for safe excision. Specially designed trocars are also adopted in percutaneous endoscopic gastrostomy (PEG), penetrating the abdominal wall directly into the stomach to create a feeding tube access tract.

III. Arthroscopic Surgery

For diagnostic arthroscopic inspection and treatment of knee, shoulder, hip and other joints, needle-type trocars create inflow channels for irrigation fluid and instrument working ports. During knee arthroscopy, an 18-gauge needle trocar is commonly inserted first to inject saline and distend the joint capsule, followed by arthroscope placement along the same tract. Their slim diameter (usually 2–3 mm) minimizes trauma to joint capsules.

IV. Drainage and Decompression

Needle-type trocars serve for puncture drainage of pleural effusion, abdominal abscess, pericardial effusion and other fluid accumulations. After localization with a fine needle, a guidewire is placed, then the cannulated drainage tube is advanced over the wire. The obturator is withdrawn and connected to a drainage bag. This method establishes drainage access in one step without repeated tissue dilation.

V. Biopsy Sampling

Under ultrasound or CT guidance, needle-type trocars perform percutaneous biopsy of solid organs including liver, kidney, lung and breast. The indwelling cannula allows multiple tissue samples to be collected without repeated punctures, lowering risks of hemorrhage and tumor seeding metastasis.

VI. Hemostasis and Suturing

Needle-type trocars function as auxiliary tools for suturing and ligation in selected endoscopic and laparoscopic procedures. For repairing gastrointestinal perforations, threaded trocars penetrate the edges of the perforation, pulling suture threads outside the body for extracorporeal knot tying.

VII. Gynecological Surgery

Trocars are indispensable for port creation in hysteroscopy and laparoscopic gynecological procedures such as myomectomy, ovarian cyst enucleation and tubal ligation. Notably, single-port laparoscopic surgery relies on a multi-channel trocar to complete the entire operation, further reducing surgical scarring.

VIII. Enhanced Visualized Puncture

Premium optical trocars integrate optical components, enabling real-time visualization of tissue layers during penetration. This eliminates blind puncture and greatly reduces risks of accidental vascular or intestinal injury, establishing a new safety benchmark for interventional access.

Conclusion

Needle-type trocars have evolved far beyond simple puncture tools to become universal, irreplaceable access interfaces within the minimally invasive healthcare system. With the advancement of surgical robots and natural orifice transluminal endoscopic surgery (NOTES), their application boundaries will keep expanding continuously.