Lars Webb, MD, Seyed Arshad, MD, Brandy Padilla-Jones, MD, Edward Auyang, MD, MS, FACS. University of New Mexico Hospital
Objective of the Device:
The Miret™ percutaneous laparoscopic instruments are low profile laparoscopic instruments with up to 10mm working tips which will allow for smaller incisions of the skin and fascia and trocarless insertion while maintaining the standard tip size.
Description of device and device usage:
The Miret percutaneous laparoscopic instruments have a 2.4mm profile shaft that connects to a 10mm working tip. Intra-corporeal assembly of the instruments allows less disruption of the skin and fascia and decreases cost by not requiring a trocar. Compared to current needle-scopic instruments, the intra-corporeal assembly of the Miret instrument allows for a standard-sized working tip which provides more axial force and a level of performance comparable with standard laparoscopic tools1,2. Currently, an Alligator grasper and Maryland dissector are available with additional device tips in in development.
Working Tip Detail
Working Tip, Percutaneous Shaft, and Introduction Tool
Two previous series looking at nonclinical efficacy of the slim profile laparoscopic tool demonstrated these tools perform on par with traditional laparoscopic instruments.   With FDA 510k clearance, the next phase was using these instruments in patients to treat their surgical pathology. The first human procedure was performed in December 2016.
Our presentation will discuss the development of this novel device, the early research regarding their efficacy, and the use in the first human case. Included will be video demonstration of the key steps in introducing, assembling, and using these instruments during a laparoscopic cholecystectomy.
Conclusions/Future study plans:
The Miret instrument has progressed from concept to FDA approval and has started usage in patients. The next phase in research will be to enroll patients in a prospective study to demonstrate parity of tradition laparoscopic surgery with laparoscopic surgery using these new slim profile laparoscopic devices.
 Dorian E, DeAsis F, Lapin B, Amesbury R, Tanaka R, Ujiki M A Comparative Assessment of Novel Mini-Laparoscopic Tools, Surgical Innovation, Sept 2016
 Webb L, Szoka N, Miskimins R, Auyang E. A New Slim Profile Laparoscopic Device – Comparing Traditional Laparoscopic Instruments and Available Slim Profile Device Using FLS Testing Protocols. SAGES Annual Meeting. Nashville, TN. April 15-18 2015
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 84327
Program Number: ET006
Presentation Session: Emerging Technology Session
Presentation Type: Podium