Hugo Bonatti. Meritus Health
Background: The Teleflex minigrasper is a 2.4mm instrument, which is inserted into the abdominal cavity without use of a Trocar. Only limited experience in general laparoscopic surgery is available. We herein report a large case series, where the minigrasper replaced a trocar based instrument.
Patients and Methods: From June 2015 to September 2018, the Teleflex minigrasper was used in 160 laparoscopic procedures including 73 cholecystectomies (LC), 51 appendectomies (LA), 25 inguinal hernia repairs (TAPP), 5 ventral hernia repairs (LVH) and 6 exploratory laparoscopies with tissue biopsy and/or lysis of adhesions.
Results: In the vast majority of cases a two port plus minigrasper technique was used including all appendectomies. In subsets of cholecystectomies (n=7 i.e. 9.5%) and bilateral inguinal hernia repairs (n=4, i.e. 16%) 3 trocars plus the minigrasper were inserted. For LC, the minigrasper was placed between an umbilical and a LUQ port and a modified dome down technique was used. For the majority of appendectomies the minigrasper was placed in the suprapubic area with 5mm ports in the umbilicus and LUQ and appendix and mesoappendix were secured using an endoloop. For inguinal hernia repair a modified transperitoneal technique was developed creating the peritoneal flaps from a subumbilical vertical incision. The minigrasper replaced the Maryland grasper during intracorporeal suturing. There were no conversions to open surgery in this series and no complications related to the minigrasper were encountered. Cosmetic results were excellent and patient satisfaction was high.
Conclusions: The minigrasper can completely replace a 5mm instrument in many commonly performed laparoscopic procedures including cholecystectomy, appendectomy and hernia repair, however, some technical modifications need to be made. Obesity does limit its usefulness.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94248
Program Number: P671
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster