New concept for Laparoscopic surgery using perbend instruments and flexible trocar,

M. Yamagata, MDPhD, M. Matsuda, MDPhD, S. Hayashi, MD, J. Sugiyama, MD, Y. Morishita, MD, K. Satoh, MD, S. Morita, MD, T. Takayama, MD, PhD

Department of Digestive surgery, Nihon University

Laparoscopic surgery were becoming to routine procedure in clinical fields. However, instrumentation of these operation include single port surgery was not enough to developed.

Instruments were able to move any direction following your image in open surgery, because instrument was able to move 3-dimention without limitation.
However movement of instruments was inconvenient in endoscopic surgery.
Because endoscopic surgery must operate as flat fields (2dimention operation).
the operation will be performed from an isologues direction and we don’t use instruments subsitute for left hand in open surgery.

Pre-bend instruments will be necessary for changing vector of dissection and traction. If pre bend instruments use operation we are able to approach behind the important structure like left hand in open surgery. In Second generation of endoscopic surgery, Flexible instruments and flexible trocar were necessary for performing operation like open surgery.

We developed the specific structural flexible trocar and reusable pre bend instrument for dissection.

An operator can set a reasonable traction to target organ in proper vector by using prebend instruments, and dissection of Vessel and Duct will be become to easy, so stress of an operator will be relieved.

It is necessary enough training for using pre bend instruments, the first Step of training is dry using training box for making image of movements for using pre bend instruments. And second step is simulation by wet lab, because movement of pre-bend instruments were extremely different compared with normal procedure.
New concept for endoscopic surgery will be able to easy for performing operation in clinical fields, however training must be received before clinical use.

Session: Poster Presentation

Program Number: P393

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