MP22-19 INNOVATION, CONSTRUCTION AND ASSESSMENT OF A NOVEL SEAMLESS LAPAROSOPIC PORT PLACEMENT SYSTEM

Abstract

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment I1 Apr 2015MP22-19 INNOVATION, CONSTRUCTION AND ASSESSMENT OF A NOVEL SEAMLESS LAPAROSOPIC PORT PLACEMENT SYSTEM Ashish Rawandale, Lokesh Patni, and Yaser Ahmad Ashish RawandaleAshish Rawandale More articles by this author , Lokesh PatniLokesh Patni More articles by this author , and Yaser AhmadYaser Ahmad More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1031AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES First port placement during transperitoneal laparoscopy is a crucial initial step having its share of morbidities. Newer ports have distinct advantages but considerable fiscal constraints e.g. optical port, cuffed disposable ports etc. Hence, today the need for a safe, reliable and cheap, reusable laparoscopic port placement system. Our innovative Laparoscopic port placement system is an attempt towards the same METHODS A survey of expectations of the type of initial port, was carried out. CAD design; patent and prototype creation done(Fig 1). Our system consists of a 2 mm diameter initial puncture needle with a safety mechanism; attached to a barometer. The needle is inserted through a 2 mm skin incision. Successful peritoneal entry is indicated by the Boyle's principal causing fluid level changes in the barometer. Wire is then introduced through the needle into the peritoneal cavity. The needle is dissembled leaving behind a rod guided system for insertion of screw dilator dilator and port. An airlock valve allows for continuous peritoneal insufflation during the safe port placement. The water well design, markings on the components and endoscopic compatibility, helps confirmation of peritoneal entry of each component at various stages. The special tip design of part 3 facilitates blunt port placement by tissue separation through the “same site” of the initial puncture. Smooth peritoneal entry; eliminates the possibility of sharp injuries RESULTS Port placement system was evaluated in 5 cases. Time to port placement was measured. Problems and disadvantages of the system were analyzed. Subjective assessment of the surgeon, assisting surgeon, anaesthetist and trolley nurse for ease of port placement was accessed with GRS scale. Post operative port site pain assessment was performed using the VAS. The port placement system demonstrated significantly lower port placement time and anxiety related to the initial port placement. Subjective port placement GRS score indicated a high degree of satisfaction on the effectiveness and safety CONCLUSIONS Our port placement system is an efficient means of safe, seamless port placement. It provides peritoneal entry confirmation using barometrics and utilises the same entry point for port placement (as the initial needle). It allows a low force, guided entry into the peritoneum. Allows visual confirmation before port placement. Maintains continuous pneumosufflation during the procedure. It is reusable and can be autoclaved. Developing such systems would help reduce healthcare costs © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e249-e250 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ashish Rawandale More articles by this author Lokesh Patni More articles by this author Yaser Ahmad More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...