New Quality in Single Port Surgery – An Innovative Surgical Technique With Fully Reusable Instruments
The recent development of minimally invasive surgery is characterized by the search for ways of further reducing access trauma for example through the use of natural orifices (NOTES) or the concentration of several individual accesses on a single incision (Single Port Surgery, SPS). Meanwhile, commercially marketed instruments have proven the technical and clinical feasibility of… Continue Reading
Transvaginal Insertion of Internal Retractor for Hybrid Notes (natural Orifice Translumenal Endoscopic Surgery) Transvaginal Cholecystectomy.
Introduction:Since the introduction of hybrid NOTES transvaginal (TV) cholecystectomy, retraction of the gallbladder has been described with magnets, percutaneos sutures and flexible long grasper. The need for adequate instrumentation gives room for improvement and development of new instrumentation. Here in we describe a novel technique for internal retraction of the gallbladder. Methods:Non-survival Hybrid Transvaginal NOTES… Continue Reading
Utilizing Modern Medical Informatics to Improve Performance and Clinical Research
Background: Modern medical informatics is changing the way physicians practice and how clinical research is conducted. The appropriate utilization of a clinical database, electronic medical records (EMR), and other health related software can improve patient care and offer the opportunity for practice analysis and HIPAA compliant research. With IRB approval, clinician researchers can use this… Continue Reading
A New Device for the Assessment of Minimally Invasive Surgical Performance – the Validity of Sequitor.
ObjectiveSeveral methods are currently used in the assessment of surgical performance. The majority depends on repeated expert review of an observed procedure. Sequitor allows identification of skilled motor behaviour using quantitative objective measures to provide additional performance characteristics, which may be advantageous during the acquisition of minimally invasive surgical skills. Description and MethodsA customized, novel… Continue Reading
Experienced Laparoscopic Surgeons Gain Significant Advantages Using 3d Passive Polarising Displays
Objective 3D surgical imaging systems provide stereoscopic depth cues that are lost in conventional 2D display systems. Recent improvements in stereoscopic projection technology using passive polarising displays have significantly improved novice surgeon performance during the acquisition of minimally invasive surgical skills. This study aims identify if passive polarising 3D displays provide similar benefits for expert… Continue Reading
Leveraging Mobile Health Technology in a Model for Home-based Primary Care: a Demonstration Project
House calls by physicians and physician extenders are time-consuming and have historically been poorly reimbursed. Nevertheless a number of factors are driving a resurgence in this form of patient-provider encounter. The burgeoning fields of mobile health technology, mobile communications and electronic medical records are converging to create new opportunities to leverage advances in a robust… Continue Reading
PVDF to Detect and Autonomously Prevent Slip During Retraction in Laparoscopic Surgery
Objective During laparoscopic surgery tissue retraction is necessary for exposure of the operating field. Currently this is performed manually by grasping the tissue in laparoscopic forceps but could be performed automatically with an appropriate device. This would need to automatically detect when tissue is slipping from its grasp and react appropriately. Method Polyvinylidene fluoride (PVDF), a piezoelectric… Continue Reading
Transanal Endoscopic Da Vinci Surgery (teds): Results of Cadaveric Experiments
Background: single port platforms and instrument are increasingly used for transanal surgery. In an effort to tackle some of the limitations and increase intraluminal flexibility, robotic integration could be a logical next step. Objective:To report on our initial experience with transanal endoscopic da Vinci surgery (TEdS) using a glove port on human cadavers. Methods: After… Continue Reading
Concurrent Limited Incision Ileostomy Reversal and Cholecystectomy via Flexible Laparoscopic Platform
Introduction: The trend towards minimally invasive procedures has progressed rapidly over the past several decades. Novel techniques and new technologies are constantly being introduced to perform increasingly complex procedures through very limited incisions. Utilization of an ostomy site for laparoscopic colorectal surgery has been described. We performed a cholecystectomy and ileorectal anastamosis (IRA) through an… Continue Reading
Modified Circular Stapler for Laparoscopic Intracorporeal Colorectal Anastomoses
Objective of the device. During standard colorectal laparoscopic resection, in order to insert the anvil with the purse-string technique, anastomosis is performed by extracting the left colon through a small laparotomy. Intracorporeal colon anastomosis avoids extensive and unnecessary colon mobilisation, but is considered technically challenging. During intracorporeal colorectal anastomoses with the circular stapler, the anvil… Continue Reading
A Modified Buess Rectoscope for TEM
Objective of the technology. TEM (Transanal Endoscopic Microsurgery) is a minimally invasive endoscopic technique, which offers excellent access and visualization of the surgical field, improving the quality of local excision for rectal lesions with full-thickness excision of the rectal wall. We have modified the Buess rectoscope in order to improve the quality and versatility of… Continue Reading
Endolumenal Full-thickness Colon-wall Resection Using an Over-the-scope-clip: Three Techniques Compared in a Porcine Survival Study
ENDOLUMENAL FULL-THICKNESS COLON-WALL RESECTION USING AN OVER-THE-SCOPE-CLIP: THREE TECHNIQUES COMPARED IN A PORCINE SURVIVAL STUDY Rieder Erwin, Mesteri Ildiko, Bolton J. Emily, Mathews F. Connor, Timmel B. Gregory, Whiteford H. Mark, Swanström L. Lee Minimally Invasive Surgery Program, Legacy Health, Portland, ORMedical University of Vienna, Austria Objective: It is widely recognized that reliable endoscopic full-thickness… Continue Reading
Sumotm System Facilitates Mucosotomy and Submucosal Tunnel Creation for Per-oral Esophageal Myotomy (POEM)
Objective:The POEM procedure for achalasia is a complex therapeutic flexible endoscopic technique, requiring extensive practice to learn. Initial experience with the POEM demonstrates that it has the potential to become the therapeutic procedure of choice in the future. However, in order for this to be achieved, the procedure needs to be simple, safe and easily… Continue Reading
DDES™ Flexible Single Incision Operating Platform Facilitates an Extended Thoracic Lymphadenectomy via a Trans-hiatal Approach.
Objective:Emphasis on extended lymph node dissection during esophagectomy is increasing. Many propose that the best technique to achieve this goal is to approach the mediastinal portion of the operation trans-thoracically. However, this may increase overall surgical morbidity compared to a purely transhiatal technique. Totally laparoscopic transhiatal esophagectomies have been performed but while better than open,… Continue Reading
Development of Metallic Reusable Port for Single Port Surgery: Possibility of Enhancement of Operability and Operation Cost Reduction
Single Port Surgery (SPS) has become used worldwide as a minimally invasive surgery method. However, many SPS ports are polymer-made disposable products, which could cause problems such as steep rise of medical cost or increase of management cost of medical waste, leading to environmental problems. We invented a metallic reusable port for SPS. Smooth fixing… Continue Reading