Single-incision Laparoscopic Cholecystectomy in Modified Lithotomy Position – Improved Ergonomics for Surgeons and Surgical Assistants
INTRODUCTION – Most single-incision laparoscopic cholecystectomy procedures described to date were done with the patient in supine position. Although convenient for the operating surgeon (standing on the patient’s left), we found this position to be taxing on a surgical assistant (who stands on the patient’s right). To alleviate the strain on the assistant’s back we… Continue Reading
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Management of the Ultrasonically Activated Scalpel Handpiece with Self-check \”bme Mode\”.
Background:Recently the ultrasonically activated scalpels have been used in many kinds of operation. Clinical Engineers (CEs) need to check the ultrasonically activated scalpel handpiece after operations. We check the handpiece by working the tip of blade in water, however, it is impossible to inspect the deterioration of the handpiece. So, self-check “BME Mode” of Harmonic®… Continue Reading
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Going back to open technique (fundus 1t) SILC
INTRODUCTION: Traditionally laparoscopic cholecystectomies are done with dissection just in the region of Calot’s triangle. With the advent of single incision laparoscopic cholecystectomies, the Calot’s triangle approach makes the procedure technically difficult to perform. In our seres of single incision laparoscopic cholecystectomies,the fundus first approach made the procedure technically easier and easily reproducible. METHODS AND… Continue Reading
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Ergonomic Performance with Crossed and Uncrossed Instruments in Single Port Laparoscopic Surgery
IntroductionThe Single Port Laparoscopic Surgery (SPLS) approach has recently emerged from efforts to reduce skin incisions and their related pain and morbidity. Preliminary research has indicated the need for instruments to be crossed at their point of insertion for reduction of the diameter of the single port. The primary objectives of this study was to… Continue Reading
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Optimal Design of Instruments for Single Port Laparoscopic Surgery Using Motion Analysis
Objective: Instruments featuring articulation of the distal tip are highly desirable when access to the surgical site is restricted, as in Single Port Laparoscopic Surgery. This study compares two types of articulating instruments which have different means of controlling the distal articulation - a controlling wheel and a controlling joint - in terms of ergonomics… Continue Reading
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Gallbladder Retraction Without Transcutaneous Sutures During Single-incision Laparoscopic Cholecystectomy
INTRODUCTION – Several techniques of retracting the gallbladder were suggested to facilitate performance of single-incision laparoscopic cholecystectomies. All require placement of transcutaneous sutures with resulting scarring, bruising and postoperative pain. We propose a new technique where gallbladder is secured to the diaphragm using intracorporeal sutures, thus allowing for more precise retraction and elimination of any… Continue Reading
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Evaluation of Commercially Available Port Access Devices for Single Incision Laparoscopic Surgery
Objectives: to evaluate three different commercially available single incision laparoscopy access devices for their ease of use. Methods: Four expert laparoscopic surgeons performed laparoscopic cholecystectomy, suturing, small bowel resection, and gastrojejunostomy through a single incision in a porcine model. A cylindrical, a disc shaped, and a sleeve based access device were evaluated for performance. Seven… Continue Reading
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