Salmai Turial, MD, Felix Schier, MD PhD. University Medical Center Mainz, Department of Pediatric Surgery
Objective
We recently developed and implemented a 2.4-mm scope. During its routine use for microlaparoscopy, we had observed a higher wastage of the mini-scope. The reason for this may be that the mini-scope becomes bent at the very end of the trocar during the laparoscopy when trying to manipulate the scope up or down. An anti-bending device was developed as a prototype in order to obtain mechanical stability and to transfer the pressure from the head of the scope down to the body of the trocar without damaging the lens. This paper will report the preliminary results using an anti-bending prototype device.
Description of the device
To transfer the pressure point from the head of the scope to the body of the trocar, we designed a collapsible telescope anti-bending device consisting of three segments. On each end of the telescope are two connectors. The top connector has screw threads exclusively for the mini-scope (0°, 18 cm length; product number SN 26005 AA, Storz, Tuttlingen, Germany) while the bottom connector has one screw thread specifically designed only for the top of the miniport (Autosuture MiniPort, 2 mm; United States Surgical Corp., Norwalk, CT, USA). The device is made of stainless steel and all five parts can be taken apart for the cleaning and sterilization process. The length of the entire anti-bending device is 10 cm (4.5cm when collapsed).
Preliminary results
The first prototype device was used during 35 laparascopic procedures. The mechanical stability of the scope has been improved. The handling of the mini-scope was not complicated while using the anti-bending device during the procedure. However, the length of the collapsed device is still too long. While using the scope together with the anti-bending device, the total working length of the scope is reduced by 5 cm. This is problematic with older children, as the trocar must be pushed further into the abdominal hole in order to receive a detailed visualization of the nearby structures. Whether the use of the anti-bending device will reduce scope wastage is to be determined in the following six month period.
Future directions
We are planning to modify the present three segment telescope prototype to a four segment telescope in order to shorten the total length of the anti-bending device. We are also looking to use hard PVC instead of stainless steel. The measurement of optical parameters of the mini-scope within and without the anti-bending device is also the subject of the next trial- phase. The bottom connector (connecting to the port) must be modified in future developments to be a general applicable connector for every kind of port.
Session: Emerging Technology Poster
Program Number: ETP044
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