Laparoscopic Hammock: Improve triangulation while minimizing tissue injury.

Kimberly A Holst, MD, Johnathon Aho, MD, Cornelius Thiels, DO. Mayo Clinic

Laparoscopic surgery continues to rapidly advance, however, there continue to be limitations in replicating open surgeries secondary to difficulty with tissue exposure. The “Laparoscopic Hammock” is a device that will facilitate triangulation without tissue injury.

Many tissues require particularly delicate manipulation which is not easily provided by current laparoscopic tools. Available instruments rely on tissue grasping, crushing, pushing, and pulling and can cause injury to both tissue to resect (known cancer, infection, mass) and tissue to preserve leading to potential complications including tumor spread, succus spillage, bowel injury, solid organ damage, and bleeding.

The “Laparoscopic Hammock” provides an alternative to traumatic tissue handling by replicating Surgeons’ handling of tissue more effectively than currently available products. This instrument utilizes a fabric mesh hammock which cradles the tissue to be retracted and allows facile manipulation to maximize efficient dissection. When the hammock deploys it is flat rather than circumferential to allow the Surgeon to precisely pace the Hammock in the desired location before engaging the magnet at the end of the fabric hammock to the magnet at distal stem of the instrument. When the magnets engage the amount of fabric deployed is fixed in a circumferential fashion, creating a secure cradle around the tissue. The Hammock can be readily disengaged by polarizing the magnets via the hand piece and readily repositioned. The Hammock is quite versatile and can be adjusted to accommodate a wide range of tissue mass to be retracted and can be deployed multiple times throughout an operation. This instrument functions through a 10-12 mm port.

The “Laparoscopic Hammock” is currently under ongoing development at our institution with collaboration between advanced laparoscopic surgeons, residents, and product engineers to optimize design. The instrument will be refined in ongoing surgical simulation settings prior to real world application. The “Laparoscopic Hammock” holds the potential to facilitate a wide range of laparoscopic operations given its versatility and gentle tissue handling.