Single-Port Laparoscopic Liver Resection: Largest Turkish Experience

Karabıçak, İlhan; Karabulut, Kağan; Yürüker, Savaş; Kesicioğlu, Tuğrul; Özen, Nurten

doi:10.1007/s12262-015-1435-0

Cited by 7 publications

(2 citation statements)

References 18 publications

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“…1 The development of articulated staplers to facilitate the division of vessels and tissue deep in transection planes such as the pelvis has been useful. 2,3 Maneuverability of surgical staplers into a precise position has been shown to allow a surgeon to reduce operation time due to making fine stapling position adjustments without having to remove the stapler. 4 Another important feature to a surgical stapler is how wide the jaw opens.…”

Section: Introductionmentioning

confidence: 99%

Improving Performance and Access to Difficult-to-Reach Anatomy with a Powered Articulating Stapler

Huang¹,

Vandewalle²,

Clymer³

et al. 2022

MDER

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Background Modern surgical staplers should provide precise placement and transection, especially in tight spaces and on thick tissue. Ideally, a stapler would move to accommodate variations in the tissue and anatomy instead of having to move the tissue around to fit the stapler. This study was undertaken to evaluate the performance characteristics of the new Echelon 3000 Stapler (ECH3). Use of the ECH3 was compared to another marketed stapler, including tests for access, seal strength, staple formation in thick tissue, and end effector stability. Methods Pelvic anatomy measurements were used to construct a virtual model of a Low Anterior Resection (LAR). Monte Carlo simulations were performed on the staplers to compare the probability of completing a transection with one or two firings. Using water infusion of stapled porcine ileum, pressure at first leak and percentage of leaks at critical pressures were measured. Rate of malformed staples was measured in thick tissue. End effector stability while firing and under moderate pressure were compared between staplers. After use, surgeons were surveyed on the functionality of the device. Results ECH3 had a markedly higher probability of completing an LAR transection in one or two firings than the comparator stapler. Median initial leak pressure of stapled ileum was significantly higher, and rate of leaks was lower at 40 and 50 mmHg. ECH3 had fewer malformed staples for both 3.3- and 4.0-mm thick tissue. The end effector exhibited less angular movement during firing, and less deflection under a moderate load. Surgeons agreed the ECH3 provided precise placement and easy one-handed operation. Conclusion The Echelon 3000 Stapler demonstrated improved access capability, tighter seals, fewer malformed staples, and greater end effector stability. These advantages were recognized by surgeons who evaluated the use of the device preclinically.

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Section: Introductionmentioning

confidence: 99%

Improving Performance and Access to Difficult-to-Reach Anatomy with a Powered Articulating Stapler

Huang¹,

Vandewalle²,

Clymer³

et al. 2022

MDER

View full text Add to dashboard Cite

show abstract

“…I have several comments to make on this article. Firstly, many types of different single-port laparoscopic procedures are being performed by expert laparoscopic surgeons (2,3). Secondly, many of the previous contraindications are no longer accepted.…”

mentioning

confidence: 99%