Akihiro Takai, MD, PhD, Yasutsugu Takada, MD, PhD, Katsunori Sakamoto, MD, Takashi Matsui, MD, Yoshitomo Ueno, MD, Takeshi Utsunomiya, MD, Masahiko Honjo, MD, Hitoshi Inoue, MD, PhD, Kohei Ogawa, MD, PhD. Ehime University Hospital
In laparoscopic surgery, we usually observe the organs in the same direction as we proceed with the dissection, in order to avoid a mirror-image situation. We are therefore unable to recognize how far the dissection has proceeded on the other side of the target organs or lesions, especially when the plane of dissection is under the mesentery or organs. This becomes a problem, because we do not understand how far the dissection has progressed and how much more dissection is needed. These situations can be seen in instances such as the medial-to-lateral approach to the white line of the left side of the descending colon for sigmoidectomy, dissection of the posterior surface of the pancreas to the upper edge of the pancreatic body or splenic artery for distal pancreatectomy, or the separation of the anterior surface of the inferior vena cava from the liver to the area between the right and middle hepatic vein for right hepatectomy. Confirming how far the dissection has progressed is currently judged by such techniques as placing gauze in the deepest position, inserting forceps into the dissection area or simply depending on the experience of the operator. When such methods do not work, procedures to confirm the dissection area may be repeated many times and can thus waste considerable amounts of time. As a solution to this problem, we developed a laparoscopic instrument with an illuminated tip. The instrument is configured by the long and narrow part made of polycarbonate resin and a battery-powered light-emitting diode to illuminate the tip by shining light through the polycarbonate resin. During the surgery, the tip of the instrument is inserted into the deepest part of the dissection area, and the transmitted light indicates how far the dissection has progressed. The tip of the instrument has a prism structure and light is emitted in a direction perpendicular to its axis. Tip position can thus be more clearly identified even with insertion in the same direction as the laparoscopic view. To verify the utility of this instrument, laparoscopic surgeries were performed in a porcine model and cadavers. We quickly and easily identified the deepest part of the dissection area even if identification had been difficult using other techniques. We consider that this instrument allows us to easily and accurately grasp the dissection range, and will contribute to safe, prompt surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 98666
Program Number: ETP778
Presentation Session: Emerging Technology Poster Session (Non CME)
Presentation Type: Poster