Quantitative Ergonomics Assessment of NOTES Techniques: A Study of Physical Workload, Body Movement and Posture
Introduction: This study investigates through biomechanical analyses NOTES and laparoscopic physical workloads. Research confirms that surgeons experience physical symptoms due to the unfavorable ergonomics of MIS performance. The ergonomics of NOTES—potentially the next evolutionary surgical step—is only now being quantitatively and systematically assessed Methods and Procedures: Six surgeons with varying MIS experience were recruited for… Continue Reading
First Human Experience with a Novel Laparoscopic Port Site Closure Device
Introduction: One of the most frustrating, difficult, time-consuming, and sometimes unreliable parts of laparoscopic surgery is closing the trocar sites, especially in obese patients. If these sites are closed improperly or not closed, the patients are at increased risk of port hernias (0.23% - 3.1%) and/or bowel incarceration possibly placing the patients’ life at risk.… Continue Reading
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- Posters
Use of a Novel, Self-contained Tissue Retraction Device to Reduce Trocar Site Number in Laparoscopic and NOTES-based Surgical Procedures
In an effort to make laparoscopic surgical procedures even less invasive, single port access and natural orifice transgastric endoscopic surgical (NOTES) approaches have been developed over the past several years. However, the need to maintain basic surgical working principles, such as proper tissue retraction to create tension and counter-tension, is still of critical importance if… Continue Reading
Use of a Novel Percutaneous Retraction Device and Magnetic Anchoring and Guidance System (mags) Helps Re-establish the Critical View and Improves Surgeon Performance While Mimicking the Four Port Technique in Single Site Laparoscopic (ssl) Cholecystectomy
Introduction: SSL, though promising, introduces ergonomic challenges due to loss of instrument triangulation as obtained in conventional laparoscopy. This limitation makes establishing the critical view during dissection of the Triangle of Calot (TOC) difficult and has resulted in a variety of strategies to overcome the problem. This study investigates use of a novel percutaneous grasper… Continue Reading
Single Site Laparoscopic (ssl) Cholecystectomy in Human Cadavers Using Novel Percutaneous Retraction and a Magnetic Anchoring and Guidance System (mags): Re-establishing the Critical View
Introduction: SSL, though promising, introduces ergonomic challenges due to loss of instrument triangulation as obtained in conventional laparoscopy. This limitation makes establishing the critical view during dissection of the Triangle of Calot (TOC) difficult and has resulted in a variety of strategies to overcome the problem. This study investigates use of a novel percutaneous grasper… Continue Reading
Application of Hem-o-lok Clip in Basic Laparoscopic Procedures: A Single Center Experience on 856 Cases and Review of Data From Food and Drug Administration
Introduction: There are several methods for ligation of structures during laparoscopic operations. Several studies have studied the efficacy, safety and cost of the various devices in different situations. Each technique has its own potential drawbacks. Applications of endoloop require dexterity and training. Endoscopic staplers are expensive instruments. Titanium clips may be slipped from its primary… Continue Reading
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Effects of Different Types of Staple Line Reinforcement on Tissue Handling and Slippage During Laparoscopic Stapling
Introduction: Staple line reinforcement (SLR) has been used to prevent staple line leaks and reduce bleeding in a variety of surgical procedures. Tissue extrusion and slippage from stapler jaws can affect tissue handling and the number of staple loads used during a procedure. We hypothesized that tissue handling and extrusion with stapler closure and firing… Continue Reading
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Single-incision Laparoscopic Cholecystectomy Using Novel Powered Articulating Instruments (terumo)
Introduction: Single-incision laparoscopic surgery (SILS) has emerged as a promising way to perform laparoscopic surgery less invasively. Currently, most SILS procedures are performed using standard laparoscopic instruments. This video demonstrates the use of novel powered articulating instruments to perform a SILS cholecystectomy in a cadaver. Methods: SILS cholecystectomy was performed through an umbilical incision in… Continue Reading
A Comparison of Independence of Motion in Single Port Access Techniques
A number of different access techniques have emerged within reduced port laparoscopy. The multi-trocar approach via separate fascial incisions and multichanneled single trocar devices have challenged reliable paradigms of multiport laparoscopy (MPL). Although benefits of the reduced port technique have yet to be proven, change has begun without comprehensive evaluation. Given that this new platform… Continue Reading
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- Posters
A New Multi-view (mv) Rigid Laparoscope
Background: Minimally invasive surgery is based on visualization with less reliance on tactile feedback. Therefore, the type of laparoscope, location of the laparoscopic working port, light transmission, viewing angle, depth of view, camera, magnification, image display and clarity are critical. Rigid laparoscopes with fixed viewing angles are the most employed worldwide because of their ease… Continue Reading
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- Posters
A Pilot Study of Using Multiphoton Microscopy to Diagnose Gastric Cancer
Introduction: Using a combination of autofluorescence from cells and second harmonic generation signal from collagen, multiphoton microscopy (MPM) imaging can provide detailed information on tissue architecture and cellular morphology. The purpose of this study was to evaluate the feasibility of using MPM to diagnose gastric cancer, compared with gold standard hematoxylin-eosin (H-E) stained histopathology.Methods: A… Continue Reading
Laparoscopic Cholecystectomy Poses Physical Injury Risk to Surgeons: Analysis of Hand Technique and Standing Position
Introduction: This study compares the effects of surgical techniques (one-handed versus two-handed) and surgeon’s standing position (side-standing versus between-standing) during laparoscopic cholecystectomy (LC) and its outcomes on surgeons’ learning, performance, and ergonomics. There is little homogeneity in how to perform and train for LC. Variations in standing position (“American” or side-standing technique where the surgeon… Continue Reading
Single Port Access Surgery: Performance Difficulty and a Possible Solution
Introduction: During single port access surgery (SPA), surgeons often find it difficult to triangulate their instruments to the target organ. Their hand movements are limited by the single port access to the abdominal cavity. The first goal of this study is to quantify the level of difficulty in performing a SPA procedure as compared to… Continue Reading
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- Posters
Neuroergonomic Assessment of the Robotic Enhancement of Minimally Invasive Surgery
Objective of the StudyMinimally invasive surgery (MIS) offers clear benefits to patients yet places increased demands on the surgeon. This is in part due to a lack of depth perception and haptic feedback and poor instrument ergonomics. Robotic assisted MIS aims to address these challenges. An example of this is Gaze-Contingent Motor Channelling (GCMC). GCMC… Continue Reading
Real-time Intraoperative Detection of Tissue Hypoxia in Endoscopic Gastrointestinal Surgery By a Novel Wireless Pulse Oximeter (wipox)
ObjectiveDehiscence or leakage following bowel anastomoses occurs at a rate of 0-50% with a high associated mortality. Vascular perfusion and tissue oxygenation (SpO2) at the anastomotic site are fundamental determinates of anastomotic viability. We aimed to construct a wireless pulse oximeter (WiPOX) to monitor intraoperative real-time tissue oxygenation, permitting the identification of unrecognized compromised blood… Continue Reading