Reduced-port surgery aided by the newly developed free jaw clip and free loop plus for local resection of gastric submucosal tumors

Fujii, Hidenori; Kawakami, Yoshiyuki; Aotake, Toshiharu; Yoshiba, Hidemaro; Doi, Koji; Onishi, Ryuhei; Hirose, Yuichi

doi:10.21037/ales.2017.02.18

Cited by 2 publications

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“…Charmant is a manufacturer of eyeglass frames. The FJ Clip has a very strong grip, and its usefulness during performance of laparoscopic surgery for gastrointestinal stromal tumor has been reported (8). The risk of organ damage due to the strong grip has been investigated in animal livers.…”

Section: Discussionmentioning

confidence: 99%

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Use of the FJ Clip for application of the marionette technique in reduced-port surgery performed for sigmoid or rectosigmoid cancer

Hirasaki¹,

Yoshiba²,

Doi³

et al. 2022

AME Surg J

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Background:We have devised a technique by which we establish the operative field and apply countertraction during performance of reduced-port surgery for sigmoid colon cancer or rectosigmoid colon cancer. The technique was devised to overcome the limitations of reduced-port surgery (RPS) and singleincision laparoscopic surgery (SILS). We applied the technique in 17 patients treated between March 2019 and April 2020.Methods: Three ports were used in all cases, a 12-mm port inserted via the umbilical fossa, a 5-mm port inserted in the right upper abdomen, and a 5-mm port inserted in the right upper lower abdomen. We used a free jaw (FJ) Clip with two pull threads to apply traction from the left upper and left lower abdominal walls (FJ Clip-marionette technique) and to thus supersede the need for assistant forceps. As with the conventional method, the medial to lateral approach was used, the surgery included appropriate lymph node dissection, and a double-stapling anastomosis or functional end-to-end anastomosis was created.Results: Patients began oral intake at a mean of 2.4 days (range, 2-3 days), and mean postoperative hospital stay was 10.3 days (range, 9-15 days). The mean number of lymph nodes retrieved was 17, with lymph node metastasis being identified in 2 patients on histopathologic examination. The mean proximal resection margin was 94.9 mm, and the mean distal resection margin was 58.5 mm. There were no postoperative complications, and there has been only 1 recurrence to date, befalling the patient with stage IV disease.Conclusions: SILS and RPS require surgical field deployment and peeling and dissection by the surgeon alone, but countertraction and the visual field are often insufficient. Use of the FJ Clip-marionette technique allows for countertraction to be maintained and a good view of the operative field. It provides for a procedure close to that of multiport surgery but without the need for an assistant surgeon.

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Section: Discussionmentioning

confidence: 99%

“…The jaw surface is textured in a lattice-like relief to resist slippage. Regulatory approval was granted in Japan, and the FJ Clip is now in clinical use (8).…”

Section: The Fj Clipmentioning

confidence: 99%

Use of the FJ Clip for application of the marionette technique in reduced-port surgery performed for sigmoid or rectosigmoid cancer

Hirasaki¹,

Yoshiba²,

Doi³

et al. 2022

AME Surg J

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Video‐assisted esophagectomy using a port‐free organ retractor for the prevention of laryngeal nerve paralysis

Sato

Nagai

Taki

et al. 2019

Asian J Endoscop Surgery

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IntroductionRecurrent laryngeal nerve (RLN) paralysis is a major complication of esophageal cancer surgery. The free jaw clip (FJ clip) was developed as an organ‐retracting device, and it can also reduce the number of ports required during surgery. Here, we describe a new technique for lymphadenectomy along the left RLN using the FJ clip.Materials and Surgical TechniqueAfter the middle and lower mediastinal lymph nodes were dissected, the upper esophagus and other tissues, including the lymph nodes and left RLN, were retracted by cutting the tracheal arteries between the esophagus and trachea and then pulling the upper esophagus to the dorsal side with the FJ clip. The esophagus was transected at the upper mediastinum, and the proximal esophagus was drawn by the FJ clip. This technique helped provide a good field of view during lymphadenectomy along the left RLN. The data of nine consecutive patients who underwent video‐assisted esophagectomy in the left lateral decubitus position by the same surgeon were reviewed. Postoperative left RLN paralysis occurred in only one patient in whom the RLN could not be preserved.DiscussionGiven the excellent short‐term outcomes with respect to left RLN paralysis, lymphadenectomy along the left RLN using the FJ clip was safe and feasible.

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Reduced-port surgery aided by the newly developed free jaw clip and free loop plus for local resection of gastric submucosal tumors

Cited by 2 publications

References 0 publications

Use of the FJ Clip for application of the marionette technique in reduced-port surgery performed for sigmoid or rectosigmoid cancer

Use of the FJ Clip for application of the marionette technique in reduced-port surgery performed for sigmoid or rectosigmoid cancer

Video‐assisted esophagectomy using a port‐free organ retractor for the prevention of laryngeal nerve paralysis

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