Introduction: Minimally invasive surgery is still in evolution. Throughout the past two decades numerous devices have been developed to enable safer and faster procedures, including anastomosis creating devices, energy sources, and superior imaging. However, retraction capabilities were put aside and currently, organ laparoscopic retraction is based on standard laparoscopic tools. In the era of minimizing the number of ports and shrinking their size, our aim was to develop internal retraction device that could be placed in the peritoneal cavity through a standard trocar, positioned for adequate retraction, and left in place for the entire procedure. These devices would obviate the need for inserting ports dedicated for retraction only and hence contribute to the reduction of the number of incisions. Herein, we present our initial experience with a novel internal liver retractor.
Laparoendoscopic single-site surgery cholecystectomy using a novel retraction device
Anthony Yuen-Bun Teoh, Jeff Siu-Wang Wong, Philip Wai-Yan Chiu, Paul Bo-San Lai and Enders Kwok-Wai Ng
The Endograb™ grasping and maneuvering system was proved as a safe and effective method to improve gallbladder retraction during LESS cholecystectomy. By eliminating the need for an extra trocar for retractor, EndoGrab™ reduced instrumental crowding of the para-umbilical incision. EndoGrab™ also showed the potential to be used successfully in additional organ retraction.
Initial results of reduced port laparoscopic gastrectomy for gastric cancer
Atsushi Iida, Takanori Goi, Daisuke Fujimoto, Yasuo Hirono, Takuma Nishino, Shigehiro Yokoi, Takeshi Watanabe, Tamotsu Togawa, Toshihisa Kimura, Hidenori Fujii
The use of EndoGrab™ laparoscopic maneuvering system allowed the procedure of a single-incision laparoscopic right hemicolectomy procedure was enabled for colon malignancy, overcoming the technical problems related to SILC (such as instrument crowding, in-line viewing, insufficient countertraction). EndoGrab™ presented excellent short-term outcomes. The use of the EndoGrab™ was essential to maintain minimal invasiveness and oncological safety, especially in difficult situations such as an unfavorable visual angle when performing a lymph node dissection around the middle colic vessels.
Utility of an Internal Retractor (EndoGrab) for the Management of the Vesicouterine Ligamentb during Laparoscopic Radical Hysterectomy
Eiji Kobayashi Mamoru Kakuda Yusuke Tanaka Akiko Morimoto Tomomi Egawa-Takata Shinya Matsuzaki Yutaka Ueda Kiyoshi Yoshino Tadashi Kimura
Leveraging EndoGrab™ proprietary MicroAnchoring™ technology ,Surgeons were able to easily reproduce a suitable surgical view that simulated the one obtained by an abdominal route for radical hysterectomy. Radical hysterectomies in all 17 cases was completed with no ureteral injuries.
Advantages of Minimal Incision Laparoscopic Cholecystectomy
Nasser Sakran MD1,2, David Goitein MD1,3, Asnat Raziel MD1, Dan Hershko MD3 and Amir Szold MD1
Two novel stand-alone maneuvering devices: EndoGrab™ and EndoLift™ were introduced during laparoscopic procedure. The gallbladder is retracted supero-laterally by the EndoGrab™ device, facilitating dissection of the structures at the Calot triangle
Single-incision laparoscopic cholecystectomy: lessons learned for success
Noam Shussman • Avraham Schlager • Ram Elazary • Abed Khalaileh • Andrei Keidar • Mark Talamini • Santiago Horgan • Avraham I. Rivkind • Yoav Mintz
The EndoGrab™ single hand application system shows an improved surgeon’s ability to perform both a safe and efficient laparoscopic procedure. EndoGrab™ retraction capabilities are versatile, retracting angels can be changed during the procedure as needed.
Providing more through less: current methods of retraction
in SIMIS and NOTES cholecystectomy
Avraham Schlager • Abed Khalaileh • Noam Shussman • Ram Elazary •
Andrei Keidar • Alon J. Pikarsky • Avi Ben-Shushan • Oren Shibolet • Santiago Horgan •Mark Talamini • Gideon Zamir • Avraham I. Rivkind • Yoav Mint
The EndoGrab™ single hand application is an easy-to-use surgeons’ support system, demonstrating optimal retraction and exposure during laparoscopic procedures, with no complications
Laparoscopic surgery, once a revolutionary approach, has evolved significantly over the years, leading to improved patient outcomes and a paradigm shift in surgical practices. This white paper delves into the latest advancements in laparoscopic techniques, instrumentation, and technologies, this paper aims to contribute to the understanding of how these innovations are reshaping the landscape of minimally
Laparoscopic surgery, often hailed as a revolutionary milestone in medical history, has significantly transformed patient care since its inception. The technique, which involves performing operations through small incisions with the aid of a camera, has drastically reduced the invasiveness of traditional surgical procedures. Emerged in the late 20th century, laparoscopy marked a paradigm shift by minimizing scarring, shortening recovery times, and lowering the risk of complications for patients. This approach has become the gold standard for various surgeries, including gallbladder removals and appendectomies. The historical trajectory of laparoscopic surgery underscores its enduring impact on enhancing surgical precision, improving patient outcomes, and shaping contemporary healthcare practices.
Instrumentation innovations in laparoscopic surgery have ushered in a new era of precision and efficiency in minimally invasive procedures. One groundbreaking advancement lies in the development of articulating instruments designed to replicate the dexterity of a surgeon’s hand. These instruments offer unparalleled precision and maneuverability, especially crucial within the restricted confines of the body during laparoscopic surgeries. The introduction of energy devices, including ultrasonic shears and advanced electrosurgical instruments, has significantly improved the efficiency of cutting and coagulation processes during procedures.
The integration of robotic-assisted surgical systems stands out as a transformative innovation in laparoscopy. These robotic systems not only provide surgeons with enhanced control but also offer three- dimensional visualization, allowing for a more detailed and accurate representation of the operative field.
This proves particularly beneficial in intricate surgeries where precision is paramount.
Moreover, the continuous evolution of imaging technologies has contributed to the refinement of laparoscopic procedures. High-definition cameras and advanced three- dimensional visualization systems empower surgeons with a clearer view, enhancing their ability to navigate and execute intricate tasks with unprecedented clarity.
Collectively, these instrumentation innovations represent a comprehensive leap forward in the realm of laparoscopic surgery, promising improved surgical outcomes and a higher standard of patient care.
Innovations in training for laparoscopic surgery have been instrumental in ensuring surgeons acquire the skills necessary for successful and precise minimally invasive procedures. Traditional training methods often involved
a transition from open surgery to laparoscopy, but contemporary approaches focus on dedicated laparoscopic training programs. Virtual reality (VR) and augmented reality (AR) simulations have emerged as groundbreaking tools, providing a realistic and risk-free environment
for surgeons to practice and refine their techniques.
These simulations enable surgeons to navigate complex anatomies, enhance hand-eye coordination, and familiarize themselves with laparoscopic equipment.
Additionally, telementoring and teleproctoring have become essential innovations, allowing experienced surgeons to remotely guide and mentor trainees during laparoscopic procedures. This not only facilitates continuous learning but also expands access to expert guidance irrespective of geographical constraints. Moreover, the integration of haptic feedback systems in training simulators adds a tactile
dimension, allowing surgeons to feel realistic resistance and forces encountered during laparoscopic procedure.
While laparoscopy is generally considered a safe and minimally invasive approach, like any surgical procedure, it is not without potential complications. Complications may include injury to surrounding structures, bleeding, infection, and complications related to anesthesia. Rigorous attention to patient safety is paramount, necessitating thorough preoperative assessments, adherence to proper surgical techniques, and meticulous postoperative care.
Continuous improvement in surgical techniques plays a pivotal role in mitigating risks and enhancing patient safety. Surgeons must stay abreast of evolving technologies, incorporate best practices, and participate in ongoing training and education.
Implementing standardized protocols, utilizing advanced imaging technologies for better visualization, and fostering a culture of open communication within surgical teams are essential components of risk reduction.
The future of laparoscopic surgery holds exciting innovations and trends that are poised to transform the landscape of minimally invasive procedures. One notable trend is the continued integration of robotic-assisted surgical systems, offering enhanced precision and three-dimensional visualization.
As these robotic systems evolve, we can anticipate even greater dexterity and control in intricate surgeries. Additionally, advancements in augmented reality (AR) and virtual reality (VR) technologies are likely to revolutionize surgical training, providing more immersive and realistic experiences for surgeons. The development of smart instruments with sensors and artificial intelligence (AI) capabilities is another promising avenue, potentially offering real-time feedback and decision support during surgeries. Furthermore, personalized and patient-specific approaches, such as tailored surgical plans based on individual anatomy, may become more prevalent. As we embrace these innovations, laparoscopic surgery is poised for a future where efficiency, precision, and patient outcomes reach unprecedented levels.
Virtual Ports Ltd pioneers advanced Minimally Invasive Surgery using its innovative MicroAnchoring™ technology. This groundbreaking devices’ platform empowers surgeons, marking a significant leap forward in procedure simplicity and effectiveness. Virtual Ports’ ‘Freedom to Operate’ initiative ensures safer, cost-effective outcomes and boosts healthcare system revenue.