Hidenori Fujii, MD, PhD, Yoshiyuki Kawakami, MD, PhD, Hidemaro Yoshiba, Toshiharu Aotake, Ryuhei Ohnishi, MD, Yoshinori Hirasaki, MD, PhD, Hajime Kato, MD, PhD, Koji Doi, MD, PhD, Yuki Hirose. Japanese Red Cross Fukui Hospital
Introduction: We pioneered development of two devices, FJ (Free Jaw) Clip and F (Free) Loop Plus, to assist with reduced port surgery. The devices are made by CHARMANT, a local precision manufacturer.
Clinical application: FJ Clip is a stainless steel that can be used to hold organs in the abdominal cavity. It is available in two sizes: 5 mm and 12 mm. The device is short, it has a strong grasp, and it causes no or only negligible organ damage. We have used FJ Clip in the performance of local gastric excision (n=13), colectomy (n=8), and cholecystectomy (n=50) with no resulting difficulty. F Loop Plus is a 21G stainless steel loop-like device into which we can insert φ0.1 mm NT alloy thread, which we draw out extracorporeally via simple puncture.
Laparoscopic total and proximal gastrectomy
We made a small incision at the umbilicus and inserted a 12-mm camera port and 6-mm metal cannula. We placed two (left and right) epigastric ports. Retraction of the left hepatic lobe was easy with use of the 12-mm FJ Clip and a 6-mm Penrose drain. For #4 lymph node dissection, we used the FJ Clip to grasp the upper part of the stomach, inserted the F Loop Plus from the upper right abdomen. For #6 dissection, we grasped the pyloric vestibule and pulled it leftward. For dissection of the upper edge of the pancreas, we grasped the left gastric arteriovenous pedicle and pulled it toward the abdomen. The FJ Clip’s grasp and traction exerted on the stomach wall were strong and effective, and there was little organ damage. Reconstruction (Roux-Y) or double tract were performed within the abdominal cavity by hand-sewn purse string suture of the esophageal stump, insertion of an anvil, and use of an automated anastomosis device. We have experienced 2 total and 3 proximally cases to date, but there have been no complications, and both intraoperative bleeding and operation time were within normal limits.
Conclusion: We believe the FJ Clip and F Loop Plus will replace conventional forceps for various tasks in reduced port gastrectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86569
Program Number: P684
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster