Laparoscopic intrapelvic operation, such as gynecological, urological and rectal operations, are often interrupted by the phenomenon of the small intestine flowing into the pelvic space. This phenomenon makes intrapelvic laparoscopic operations difficult. Although, patients are placed in an extreme head down position to keep the pelvic space wide to prevent this interruption of the small intestine, the position has adverse effects on breathing and the circulatory system of a patient.
We developed a tool for removing the small intestine from the pelvic space using with a new concept. The tool, a catheter of 10 Fr. in diameter and 450cm in length with an apical balloon (KY-tube), is very simple. The KY-tube is inserted nasally three or four days before the operation. The balloon tip of the KY-tube should reach the large intestine or beyond anus by the operative day.
The KY-tube is used as follows: A the beginning of the laparoscopic operation, an operator clumps the terminal ileum with a detachable vessel clip. Next, an assistant pulls on the nasal end of the KY-tube. The KY-tube then slips under the vessel clip, and become fixed when the apical balloon reaches the clip. The assistant then pulls on the tube more, and the small intestine is gathered up and shortened. Finally, the small intestine is moved out of the pelvic space.
We have used the KY-tube clinically in 12 cases, and could intrapelvic operative procedures successfully without interruption of the small intestine. During these operations, the patient head down position was not required. We have experienced no complications with the KY-tube throughout any operation.
Program Number: P094