Artikel
Innovative Intraabdominal Retraction Systems for Liver and Colon for Single Port Bariatric and Colorectal Surgery
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Veröffentlicht: | 24. April 2015 |
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Background: Retracting the liver in bariatric surgery is a crucial part and often represents the need for a second assistant or an expensive retractor. Olorectal surgery in obese patients represents also a challenge when performing reduced-port surgery. Innovative retraction systems may allow for reducing the access trauma in this set of indications.
Methods: Since 2012, intraabdominal retraction with a variety of technologies were applied to single port bariatric and colorectal surgery. The technologies may overcome the difficulties in retracting voluminous livers by a single application at the beginning of the procedure. Indications were: 1. No-trocar liver retraction using VersaLifter BAND®. 2. Liver retraction via a bivalve suction system (LIVAC®., Australia). 3. Intraoperative colon retraction was performed with a cellulose compressed sponge Endoractor®.(Kawamoto Corp, Japan), and with a needle retractor T-Pea Lifter®. 4. Rectal retraction was achieved with VERSA-Lifter Systems (France).
Results: All 48 patients from both genders with body mass index (BMI) between 28-54Kg/m2 with indication for laparoscopic colorectal or bariatric surgery were prospectively documented. Instead of usual laparoscopic retraction, the devices were applied at the beginning of the operation allowing reducing the ports in two points of the anterior parietal wall of the abdomen and stretching the band under the left lobe of the liver.
Conclusions: No trocar retractions were successgfully applied in unselected routine laparoscopic colorectal and bariatric surgery. The novel systems showed feasibility and safety, allowing reduction of surgical ports or single port in bariatric and colorectal surgery.