Abstract
Background As the field of minimally invasive surgery continues to develop, surgeons are confronted with the challenge of performing conventional laparoscopic surgeries through fewer incisions while maintaining the same degree of safety and surgical efficiency. Most of these methods involve elimination of the ports previously designated for retraction. As a result, minimally invasive surgeons have been forced to develop minimally invasive and ingenious methods for providing adequate retraction for these procedures. Herein we present our experience using endoloops and internal retractors to provide retraction during Single Incision Minimally Invasive Surgery (SIMIS) and Natural Orifice Transluminal Endoscopic Surgery (NOTES) cholecystectomy. We also present a review of the alternative retraction methods currently being employed for these surgeries. Methods SIMIS was performed on 20 patients and NOTES was performed on 5 patients at our institution. Endoloops or internal retractors were used to provide retraction for all SIMIS procedures. Internal retractors provided retraction for all NOTES procedures. Results Successful cholecystectomy was accomplished in all cases. One SIMIS surgery required conversion to standard laparoscopy due to complex anatomy. There were no intraoperative complications. Although adequate retraction was accomplished in all cases, the internal retractors were found to provide superior and more versatile retraction comparedto that of endoloops. Conclusion Adequate retraction greatly simplifies SIMIS and NOTES surgery. Endograb internal retractors were easy to use and were found to provide optimal retraction and exposure during these procedures without complications.
Original language | English (US) |
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Pages (from-to) | 1542-1546 |
Number of pages | 5 |
Journal | Surgical Endoscopy and Other Interventional Techniques |
Volume | 24 |
Issue number | 7 |
DOIs | |
State | Published - Jul 2010 |
Externally published | Yes |
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Keywords
- Instruments
- Laparoscopic cholecystectomy
- Retraction
ASJC Scopus subject areas
- Surgery
- Medicine(all)
Cite this
Providing more through less : Current methods of retraction in SIMIS and NOTES cholecystectomy. / Schlager, Avraham; Khalaileh, Abed; Shussman, Noam; Elazary, Ram; Keidar, Andrei; Pikarsky, Alon J.; Ben-Shushan, Avi; Shibolet, Oren; Horgan, Santiago; Talamini, Mark; Zamir, Gideon; Rivkind, Avraham I.; Mintz, Yoav.
In: Surgical Endoscopy and Other Interventional Techniques, Vol. 24, No. 7, 07.2010, p. 1542-1546.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Providing more through less
T2 - Current methods of retraction in SIMIS and NOTES cholecystectomy
AU - Schlager, Avraham
AU - Khalaileh, Abed
AU - Shussman, Noam
AU - Elazary, Ram
AU - Keidar, Andrei
AU - Pikarsky, Alon J.
AU - Ben-Shushan, Avi
AU - Shibolet, Oren
AU - Horgan, Santiago
AU - Talamini, Mark
AU - Zamir, Gideon
AU - Rivkind, Avraham I.
AU - Mintz, Yoav
PY - 2010/7
Y1 - 2010/7
N2 - Background As the field of minimally invasive surgery continues to develop, surgeons are confronted with the challenge of performing conventional laparoscopic surgeries through fewer incisions while maintaining the same degree of safety and surgical efficiency. Most of these methods involve elimination of the ports previously designated for retraction. As a result, minimally invasive surgeons have been forced to develop minimally invasive and ingenious methods for providing adequate retraction for these procedures. Herein we present our experience using endoloops and internal retractors to provide retraction during Single Incision Minimally Invasive Surgery (SIMIS) and Natural Orifice Transluminal Endoscopic Surgery (NOTES) cholecystectomy. We also present a review of the alternative retraction methods currently being employed for these surgeries. Methods SIMIS was performed on 20 patients and NOTES was performed on 5 patients at our institution. Endoloops or internal retractors were used to provide retraction for all SIMIS procedures. Internal retractors provided retraction for all NOTES procedures. Results Successful cholecystectomy was accomplished in all cases. One SIMIS surgery required conversion to standard laparoscopy due to complex anatomy. There were no intraoperative complications. Although adequate retraction was accomplished in all cases, the internal retractors were found to provide superior and more versatile retraction comparedto that of endoloops. Conclusion Adequate retraction greatly simplifies SIMIS and NOTES surgery. Endograb internal retractors were easy to use and were found to provide optimal retraction and exposure during these procedures without complications.
AB - Background As the field of minimally invasive surgery continues to develop, surgeons are confronted with the challenge of performing conventional laparoscopic surgeries through fewer incisions while maintaining the same degree of safety and surgical efficiency. Most of these methods involve elimination of the ports previously designated for retraction. As a result, minimally invasive surgeons have been forced to develop minimally invasive and ingenious methods for providing adequate retraction for these procedures. Herein we present our experience using endoloops and internal retractors to provide retraction during Single Incision Minimally Invasive Surgery (SIMIS) and Natural Orifice Transluminal Endoscopic Surgery (NOTES) cholecystectomy. We also present a review of the alternative retraction methods currently being employed for these surgeries. Methods SIMIS was performed on 20 patients and NOTES was performed on 5 patients at our institution. Endoloops or internal retractors were used to provide retraction for all SIMIS procedures. Internal retractors provided retraction for all NOTES procedures. Results Successful cholecystectomy was accomplished in all cases. One SIMIS surgery required conversion to standard laparoscopy due to complex anatomy. There were no intraoperative complications. Although adequate retraction was accomplished in all cases, the internal retractors were found to provide superior and more versatile retraction comparedto that of endoloops. Conclusion Adequate retraction greatly simplifies SIMIS and NOTES surgery. Endograb internal retractors were easy to use and were found to provide optimal retraction and exposure during these procedures without complications.
KW - Instruments
KW - Laparoscopic cholecystectomy
KW - Retraction
UR - http://www.scopus.com/inward/record.url?scp=77955662685&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955662685&partnerID=8YFLogxK
U2 - 10.1007/s00464-009-0807-6
DO - 10.1007/s00464-009-0807-6
M3 - Article
C2 - 20035352
AN - SCOPUS:77955662685
VL - 24
SP - 1542
EP - 1546
JO - Surgical Endoscopy
JF - Surgical Endoscopy
SN - 0930-2794
IS - 7
ER -