Covidien

Abstract:

We recently developed an oval-shaped E•Z Access device designed exclusively for use with the LAP PROTECTOR™ Oval type device (Hakko Co. Ltd., Tokyo, Japan). The transverse abdominal opening diameter made by round-shaped (Alexis® Wound Retractor, Applied Medical, Rancho Santa Margarita, CA; and LAP PROTECTOR™ Round type) and oval-shaped (LAP PROTECTOR™ Oval type) wound retractors was measured and compared in 5 patients with cholecystolithiasis. Each device was placed through a single 25-mm longitudinal umbilical incision, and the length of trocar separation was compared. LESS cholecystectomy was then performed using the oval-shaped E•Z ACCESS/LAP PROTECTOR™. The transverse abdominal opening diameter was maximized with the LAP PROTECTOR™ Oval type device. The average distance between the working-ports for the glove method, round-shaped, and oval-shaped E•Z ACCESS/LAP PROTECTOR™ devices in the 25-mm umbilical incisions were 20 ± 0.8 mm, 24 ± 1.5 mm, and 35 ± 0.8 mm, respectively. Wider trocar separation was achieved using the oval-shaped device, making the surgical procedures easier to perform. No perioperative port-related or surgical complications were observed. LESS cholecystectomy using the E•Z ACCESS Oval type device was found to be technically feasible. The Oval type device appears to allow for wider trocar separation, thereby reducing stress on the surgeon, ensuring patient safety, and providing cosmetic benefits.

Authors:

Kazunori Shibao, MD, PhD, Assistant Professor, Department of Surgery I, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan, Tsuyoshi Takagi, MD, PhD, Deputy Director, Department of Surgery, Nishijin Hospital, Kyoto, Japan, Aiichiro Higure, MD, PhD, Associate Professor, Department of Surgery I, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan, Koji Yamaguchi, MD, PhD, Professor, Department of Surgery I, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan

PMID: 23860933

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