Single Port Surgery Made Easy with Internal Retractors

Achieving adequate retraction and exposure during abdominal surgery is a fundamental requirement. In traditional open surgery retraction is achieved by the surgeons’ hands and mechanical devices anchored to the operating table. During laparoscopy dedicated incisions are performed and instruments are inserted into the peritoneal cavity for this purpose alone. For example, during a standard laparoscopic cholecystectomy two trocars are devoted for retraction purposes only. Single port surgery reduces the number of abdominal wall incisions and may lower the post operative pain, reduce the risk for surgical wound infection, reduce the risk of developing post operative incisional hernias and improve the cosmetic results. Achieving adequate retraction in this approach is critical yet difficult and quite challenging even when using novel articulating instruments.
The EndoGrab™ is an internally anchored device, which retracts organs to the internal abdominal wall. It is introduced into the peritoneal cavity through a 5mm trocar at the beginning of the operation, and is removed following completion of the procedure. A flexible endoscope and articulating instruments provide the necessary triangulation, and the internal retractors provide the necessary retraction, therefore making single port procedures realistic.
Following IRB approval we conducted a study for evaluating the safety and efficacy of these retractors in a single port cholecystectomy. The procedures will be presented and the implications discussed.
One of the major obstacles in single port surgery is achieving adequate retraction. Internal retractors such as the EndoGrab™ can now be safely positioned through a 5mm working port and left behind leaving the trocar and surgeons hands free for dissection. These endoretractors will hopefully pave the way to implementing single trocar procedures more extensively.

Session: Podium Video Presentation

Program Number: V041

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