Mechanical Evaluation of Three Access Devices for Laparo-endoscopic Single site Surgery

Jiangfan Zhu, MD

East Hospital, Tongji University School of Medicine

Background
Many kinds of port access devices were developed for laparo-endoscopic single site surgery (LESS) during recent years. Which port is best suitable for this relatively new technique needs to be investigated. The aim of this study was to evaluate the common used port access devices by using the mechanical approaches in a training simulator.

Methods
Three commercially available access devices, Multi-ports, TriPort and SILS Port were evaluated. A LESS mechanical evaluation platform was set up to investigate the forces on the instrument when it was moving along both horizontal and vertical axes in the access devices. In addition, a strain force measurement system was utilized to compare the average load on the ports when conducting the standard maneuvers, and the task completion time was recorded when completion of the maneuvers in these different access ports.

Results
Comparison of the forces on the instrument in horizontal displacement in these ports, the forces for Multi-ports were significantly less than the other two ports(P<0.05). When the instrument entering the ports, the friction forces applied along the vertical axis were Multi-ports < SILS Port <TriPort, and those when it was pulled were Multi-ports <TriPort< SILS Port. There was statistically significance among all groups(P<0.05). Comparing of the average load required to perform the task, the average load was less for Multi-ports than for TriPort (P<0.001). Similarly, the SILS Port was significantly less than TriPort for the average load needed (P<0.05), but no significant differences between Multi-ports and SILS Port were detected (P>0.05). The faster task times were presented when using Multi-ports than SILS Port or TriPort (P<0.005), but the difference between SILS Port and TriPort was not significant.

Conclusions
Compared with Triport and SILS Port, Multi-ports are associated with the least average load and shortest task performance times in a training simulator. This study shows that Multi-ports may offer better maneuverability for LESS performance.

Session: Poster Presentation

Program Number: ETP001