Port Arrangement Research Articles

Frequency-tunable logic gates in graphene nano-waveguides

In this study, simple basic plasmonic logic gates of XOR, OR, and NOT based on graphene nano-ribbon resonators coupled to properly designed arrangements of nano-waveguides, as input and output logic ports, are demonstrated. The operation of the structures as frequency selective components is based on the propagation of edge modes in nano-waveguides and coupling to nano-ribbon resonators located in appropriate locations. The gates performance is investigated through analytic approaches and verified numerically using the finite difference time domain method. Typical extinction ratio of about 8 dB between ON and OFF logic states has been attained. According to the fantastic feature of voltage-dependent chemical potential of graphene conductivity, the characteristics of the structures can be actively manipulated. These sub-wavelength plasmonic components can be employed extensively in terahertz demanded applications.

Four‐port shared rectangular radiator with defected ground for wireless application

SummaryIn this research work, a modified shared rectangular radiator is proposed for 5.7‐GHz wireless application using multiple cuts and partially stepped ground. The shared design requires no isolating structure to decouple the ports. The proposed shared geometry produces >13 dB isolation in the 4.4‐ to 6.4‐GHz operating band. The gain varies from 3.0 to 6.2 dBi, and radiation efficiency is >70 % in the band. The mutual coupling among the port is reduced by orthogonal arrangement of ports, and envelope correlation coefficient (ECC) is <0.04 in the presented band. Apart from this, isolation in the proposed shared radiator is enhanced by additional multiple cuts with stepped ground. The indoor‐outdoor suitability of multiple input multiple output (MIMO) antenna for isotropic and Gaussian medium is checked by mean effective gain (MEG) and specific absorption rate (SAR). The presented results of MEG and SAR fulfill the required safety norms as per the ITU for different environments.

Micromachined Filters at 450 GHz With 1% Fractional Bandwidth and Unloaded <italic>Q</italic> Beyond 700

This letter presents two silicon-micromachined narrowband fourth-order waveguide filter concepts with center frequency of 450 GHz, which are the first narrowband submillimeter-wave filters implemented in any technology with a fractional bandwidth as low as 1%. Both filters designs are highly compact and have axial port arrangements, so that they can be mounted directly between two standard waveguide flanges without needing any split-block interposers. The first filter concept contains two TM110 dual-mode cavities of circular shape with coupling slots and perturbations arranged in two vertically stacked layers, while the second filter concept is composed of four TE101 series resonators arranged in a folded, two-level topology without crosscouplings. Prototype devices are fabricated in a multilayer chip platform by high-precision, low-surface roughness deep-silicon etching on silicon-on-insulator wafers. The measured passband insertion loss of two prototype devices of the dual-mode circular-cavity filters is 2.3 dB, and 2.6 dB for three prototypes of the folded filter design. The corresponding extracted unloaded quality factors of the resonators are 786 ± 7 and 703 ± 13, respectively, which are the best so far reported for submillimeter-wave filters in any technology. The presented filters are extremely compact in terms of size; their footprints have areas of only 0.53 and 0.55 mm2, respectively, and the thickness between the waveguide flanges is 0.9 mm.

Combined laparoscopic and robotic surgery for synchronous colorectal and genitourinary cancer: A case series

IntroductionAdvances in diagnostic techniques and treatment have resulted in an increase in patients with synchronous cancer. Surgical reports of combined laparoscopic and robotic resection for synchronous colorectal and genitourinary cancer are rare. Materials and methodsBetween August 2015 and November 2017, three patients underwent combined laparoscopic and robotic surgery for synchronous colorectal and genitourinary cancer in our hospital. ResultsCase 1 was a 59-year-old man with synchronous rectal and prostate cancer treated by combined laparoscopic anterior resection and robotic-assisted prostatectomy. Case 2 was a 77-year-old man with synchronous cancer of transverse colon and left kidney treated by combined laparoscopic transverse colectomy and robotic-assisted partial nephrectomy. Case 3 was a 74-year-old man with synchronous adenocarcinoma of descending colon and prostate treated by combined laparoscopic left hemicolectomy and robotic-assisted prostatectomy. DiscussionIn simultaneous endoscopic surgery, it is necessary to consider sequence of resection, intraoperative position of patient and port arrangement. Simultaneous surgery allows promptly for postoperative adjuvant chemotherapy. ConclusionCombined laparoscopic and robotic surgery for synchronous colorectal and genitourinary cancer is suitable for advanced cancer cases requiring multidisciplinary treatment.

Reduced-port gastrectomy for gastric cancer with similar port arrangement to conventional five-port laparoscopic gastrectomy

In the recent years, approaches such as reduced-port surgery have garnered much attention because of their minimally-invasive nature and improved cosmetic outcomes. Many different types of reduced-port gastrectomy (RPG) for gastric cancer have been reported, and the optimal port size and their arrangement have not yet been established. The authors perform RPG for gastric cancer using an umbilical multi-channel port (MCP) and two needle forceps. In our procedure, a laparoscope and two 5-mm instruments are inserted through umbilical MCP (GelPOINT). The surgeon stands on the patient’s right side and manipulates the conventional laparoscopic instruments through GelPOINT and right upper abdominal wall needle forceps. The first assistant on the patient’s left side uses the forceps inserted through GelPOINT and the left upper abdominal wall needle forceps. Gastrectomy with lymphadenectomy and reconstruction are performed using the same technique as that of conventional five-port laparoscopic gastrectomy (LG). We have successfully used this procedure in over 60 patients with gastric cancer. Our technique for RPG employs the same number of instruments and similar port arrangement as used in conventional five-port LG. This procedure can also achieve almost the same postoperative pain reduction and excellent cosmetic outcomes as observed with single-port gastrectomy.

The design and influence of port arrangement on an improved wave rotor refrigerator performance

The port width and the offset between them are important structure parameters of a wave rotor refrigerator (WRR). The arrangement of ports decides the wave diagram in the wave rotor, which has a huge influence on the WRR performance. Designing a wave rotor mainly focuses on predicting the behavior of shock and expansion waves in wave rotor channels. This paper first presents an analytical design procedure for the pressure exchanger refrigerator, also known as WRR, to afford a theoretical port arrangement of the WRR rapidly. Then, the analytical design results are used as initial numerical model for CFD calculation. Based on the numerical simulation results, the port arrangements can be optimized. Charts and explanations are presented for the optimum design. Furthermore, a series of experiments were conducted to investigate the WRR performance under the optimized port sizes and offset. The results suggest that the COP of the system greatly changes with the geometrical arrangements. The highest COP of the system may be reduced by 41.8% with improper port widths or positions. The analysis of the WRR refrigeration system performance has revealed that expansion efficiency can be adversely affected by the compression efficiency, which means the improved WRR system have a great resistance to the working condition of volatility.

Design and dynamic characteristic prediction of air-powered twin-rotor piston engine

A novel air-powered twin-rotor piston engine (ATPE) utilizing a differential velocity driving mechanism to achieve a high output torque was proposed. The ATPE had eight separated rotary cylinders which can dynamically enlarge the engine displacement as a result of the special driving mechanism, which was named dynamic volume expansion. The mathematical model of ATPE comprising a dynamic model and a thermodynamic model was established under the assumption of no mechanical friction. The model was numerically simulated in Matlab. The results show that shortage of low output torque confusing traditional air-powered engines can be overcome. The average output torque sharply increases to 100 N·m, which is about three times that of traditional air-powered engines with equal cylinder displacement under the pressure of 0.6 MPa at 480 r/min. ATPE can be used to drive vehicles directly without transmission box, therefore the energy transfer efficiency of ATPE can be increased. Furthermore, benefitting from the novel gas distribution system, the engine shows an ability in self-adjusting under different loads. The arrangements of air ports automatically adjust the open interval of air ports according to the load, which may simplify the speed control system.

Effect of Transverse Aspect Ratio and Distinct Ventilation Techniques on Convective Heat Transfer from a Rectangular Enclosure: Experimental and Numerical Study

Our objective in this study was to investigate the convective heat transfer in a cavity with ventilation ports. The study has been divided into experimental and numerical sections and under the experimental study the enclosure considered with two exit ports at roof and one inlet opening with varying aspect ratio. Under the numerical study, the model validation is done at AR = 5, and then the study continued for one exit port each on the left side and right side. The enclosure is equipped with three discrete heat sources at the bottom wall and with an exhaust fan at the exit port. The ranges of parameters considered under experimental study as 1.25 ≤ AR ≤ 2.5, 3224 ≤ Re ≤ 6579, 8.5 × 106 ≤ Gr ≤ 1.03 × 108, and as a consequence Richardson number obtained in the range 0.21–9.58. Experimental results set out that the heat source surface Nusselt number decreases with an increase in aspect ratio however; at higher aspect ratio, the values of Nusselt number remain almost unchanged. The enclosure bulk fluid Nusselt number increases with an increase in aspect ratio. The study revealed that for a given aspect ratio with an increase in Re, the heat source Nu increases. The numerical study divulged that the ventilation port arrangement at the right side of enclosure exhibits the better thermal performance among all the three orientations considered and the results are supported with the streamline and temperature contours. The study of varying inlet port height disclosed that as the inlet port height is increased, the heater surface temperature drops and the enhanced heat transfer is achieved.

Effects of suction port arrangements on a scroll expander for a small scale ORC system based on CFD approach

Blocking effect of the orbiting scroll tip on the suction flow of a scroll expander, closely associated with the location of the suction port, has a vital role on the transient performances of the expander. In this study, CFD based 3D numerical simulations were performed on scroll expanders with different suction port locations to estimate transient features of the aerodynamic parameters including pulsating mass flow rate through the suction port, asymmetric distributions of the internal flow, gas forces and moments exerted on the orbiting scroll. The results illustrate the pulsating features of the suction mass flow rate, in response to both variations of the suction flow area and the suction chamber volume, change obviously for expanders with different suction port locations. A special aerodynamic separation of the suction chamber induces a sudden drop of the suction mass flow rate before the top profile meshing. Apart from the mass flow rate, both the fluctuating intensities and the magnitudes of the gas forces and moments change with different suction port locations as well. A proposed local analysis approach on the driving moment indicates the fluctuations of the driving moment in different time periods are induced by different factors, and transient moment features of all scroll segments are closely associated with the asymmetric pressure distribution which is an integrated result of the suction/discharging flows and the eccentric rotation of the orbiting scroll.

Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

Pure laparoscopic hepatectomy is a less invasive procedure than conventional open hepatectomy for the resection of hepatic lesions. Increases in experiences with the technique, in combination with advances in technology, have promoted the popularity of pure laparoscopic hepatectomy. However, indications for usage and potential contraindications of the procedure remain unresolved. The characteristics and specific advantages of the procedure, especially for hepatocellular carcinoma (HCC) patients with chronic liver diseases, are reviewed and discussed in this paper. For cirrhotic patients with liver tumors, pure laparoscopic hepatectomy minimizes destruction of the collateral blood and lymphatic flow from laparotomy and mobilization, and mesenchymal injury from compression. Therefore, pure laparoscopic hepatectomy has the specific advantage of minimal postoperative ascites production that leads to lowering the risk of disturbance in water or electrolyte balance and hypoproteinemia. It minimizes complications that routinely trigger postoperative serious liver failure. Under adequate patient positioning and port arrangement, the partial resection of the liver in the area of subphrenic space, peri-inferior vena cava area or next to the attachment of retro-peritoneum is facilitated in pure laparoscopic surgery by providing good vision and manipulation in the small operative field. Furthermore, the features of reduced post-operative adhesion, good vision, and manipulation within the small area between the adhesions make this procedure safer in the context of repeat hepatectomy procedures. These improved features are especially advantageous for patients with liver cirrhosis and multicentric and/or metachronous HCCs.

The Effect of Air Injection Method on the Airlift Pump Performance

With simple structure, excellent reliability, low cost, no restriction at depth of water, and easy control and operation, airlift pumps have special advantage in borehole hydraulic jet mining, river dredging and deep sea mining. To clarify the mechanism and process of action of air injection methods on air lift performance, and to enhance lifting capacity, the pump performance of a small airlift system in transporting river sands is investigated experimentally in the present study. The results are as the follows. The influences of air exit ports on water volume flow rate, mass flow rate of solids and lifting efficiency are studied and found to be very low when the number of air exit ports exceeds 3. The pump design show best pumping capability for water and solids at higher air flow rates, but the lifting efficiency is then very low. In addition, a dimensionless equation which describes the flows in the pipe is presented based on the Bernoulli equation, and compared with measurement results in the dimensionless form, which are nearly in good agreement with each other for all the arrangements of air exit ports and are basically contained within ±18% of the theoretical curve. The results are important for understanding the mechanism of airlift pumps and enriching multiphase flow theory.

A Low-Cost Wideband 77-GHz Planar Butler Matrix in SIW Technology

This communication presents a low-cost 77-GHz switched-beam slot antenna array driven by a Butler matrix. In the proposed configuration, four broadband couplers are combined and crossovers are effectively avoided. In this case, the overall circuit and beamforming network losses are considerably reduced. A 4 × 4 planar SIW Butler matrix is designed and demonstrated for integrated beamforming network applications, which exhibits about 7 degrees phase error and ±0.75 dB coupling imbalance over 11% bandwidth. This experimentally prototyped matrix is integrated with a four-array slot antenna on the same substrate. An alternating displacement of the slots in subsequent radiating waveguides is proposed to save the arrangement of the input ports and to achieve broadband performances. Measured radiation patterns are in good agreement with simulated counterparts over the proposed 77-GHz frequency range.

The Influence of Spatial Filters on Infrasound Array Responses

A spatial filter is often attached to a microphone or microbarometer in order to reduce the noise caused by atmospheric turbulence. This filtering technique is based on the assumption that the coherence length of turbulence is smaller than the spatial extent of the filter, and so contributions from turbulence recorded at widely separated ports will tend to cancel while those of the signal of interest, which will have coherence length larger than the spatial dimensions of the filter, will be reinforced. In this paper, the plane wave response for a spatial filter with an arbitrary arrangement of open ports is determined. It is found that propagation over different port-to-sensor distances causes out-of-phase sinusoids to be summed at the central manifold and can lead to significant amplitude decay and phase delays as a function of frequency. The determined spatial filter plane wave response is superimposed on an array response typical of infrasound arrays that constitute the International Monitoring System infrasound network used for nuclear monitoring purposes. It is found that signal detection capability in terms of the Fisher Statistic can be significantly degraded at certain frequencies. The least-squares estimate of signal slowness can change by up to 1.5° and up to 10 m/s if an asymmetric arrangement of low and high frequency spatial filters is used. However, if a symmetric arrangement of filters is used the least-squares estimate of signal slowness is found to be largely unaffected, except near the predicted null frequency.

Development of a 17-Hole Omnidirectional Pressure Probe

M ULTIHOLE pressure probes are the most common measurement technique to measure velocity vector, static and total pressure in three-dimensional flowfield. Their general principles, calibration methods, and data reduction algorithms have been studied in depth and documented well [1–10]. Conventional fiveor seven-hole probes are capable of measuring flow velocity vector up to 75 deg from the probe axis [6]. For highly three-dimensional flow, the 18or 12-hole probes recently developed by Rediniotis and Kinser [11] and Ramakrishnan and Rediniotis [12] are capable of measuring velocity vector up to nearly 160 deg from the probe axis. A general data reduction algorithm has been developed for these kinds of omnidirectional probes [13]. The algorithm is based on extensive calibration and coordinate transformation technique, which is suitable for the nonconventional probes since it does not require the ports to be distributed symmetrically. Nevertheless, conventional data reduction algorithms based on interpolation still find their merit with simplicity, robustness, and accuracy. By using partitioning technique, an interpolation-based algorithm is fully competent for the omnidirectional probes. In this work, a 17-hole omnidirectional pressure probe was designed and fabricated for three-dimensional flowfield measurement. The idea is initiated from the 18-hole probe and the port arrangement is essentially same as the 18-hole one but with one port substituted by the sting.With this configuration, all pressure ports are symmetric to the probe axis, whichmakes holding and positioning of the probe easier in fabrication as well as in measurement. Furthermore, in the 18-hole probe, the distance from the rim of the three holes beside the sting to the sting surface is around 35% of the sting diameter. The pressure reading from these holes is influenced by the sting remarkably. In the 17-hole probe, this distance extends to 70% of the sting diameter.Meanwhile, the 17-hole probe is still capable of measuring similar angular range as the 18-hole probe. Six zones are used in the 18-hole probe in [11] with each zone resembles afive-hole probe and is in charge of a cone angle of 60 deg, which makes some ports locate at cone angle of 105 deg maximally. This angle range is problematic since the boundary layer separates at around 85 deg for a laminar flow. In [13], this problem is solved with a newly developed data reduction algorithm that uses three ports for angle detection. The new algorithm is still not an optimal choice because the fewer ports are used (smaller angle difference between the ports equivalently), the less sensitive pressure coefficients are to the objective angle. Measurement accuracy for flow angle is then compromised, especially when pressure measuring error is relatively large. A more adaptable and straightforward data reduction algorithm was developed for the 17-hole probe. Seventeen zones are schemed that can be classified into five-hole-pattern zones and seven-holepattern zones. For a five-hole-pattern zone, cone angle of the farthest port is 67.5 deg; for a seven-hole-pattern zone, cone angle of the farthest port is 90 deg. Furthermore, the seven-hole-pattern zone is divided into three subzones, which makes cone angle of the farthest port reduce to 70 deg. The remainder of this paper discusses the design and fabrication of the probe, data reduction algorithm, and its calibration.

Reconfigurable RF Quadrature Patch Hybrid Coupler

A highly reconfigurable radio frequency patch hybrid coupler with a simple topology is presented for the first time. Due to the introduction of lumped equivalent circuit and flexibility of varactor loaded patterned ground plane, the complex reconfigurability in port arrangement and coupling coefficient can be implemented. Varying the capacitance across different planes allows the electronic switching between different operating modes of the patch hybrid coupler. When the auxiliary patch and patterned ground plane is placed closer to the two output ports, tunable coupling coefficient can also be implemented by changing the capacitance. This results in wide band reconfigurability for the coupling coefficient range. For demonstration purposes, a patch hybrid coupler operating at 2.4 GHz is designed and measured to validate the port reconfigurable concept. Also, a patch hybrid coupler with tunable coupling coefficient operating at 3.5 GHz is designed, fabricated, and measured. This circuit gives a reconfigurable coupling coefficient ranging from -4.2 to -10 dB while maintaining good performance.

Bilateral Robot-Assisted Ureteroneocystostomy: The Ergonomic Advantages of the DaVinci System

Introduction: Laparoscopy and robot-assisted surgery have been proven to be efficacious and beneficial in the management of ureteral injuries.1,2 From 2003 to 2010 we have performed 35 laparoscopic ureteral re-implantation, 4 of them bi-lateral. In this video we present our first approach to a robot-assisted extra-vesical bilateral ureteroneocystostomy in regard to ergonomic advantages offered by the DaVinci® system, feasibility, safety, and short-term results. Materials and Methods: A 55-year-old woman with a bilateral ureteric transection after a radical hysterectomy came to our vision. The day after the gynecological surgery, urine collection from the drain and subsequent intravenous urography confirmed an iatrogenic bilateral injury. We proceeded to the placement of bilateral nephrostomy; 6 weeks later, we performed a robot-assisted bilateral ureteroneocystostomy according to an extra vesical Lich-Gregoir technique. The camera is placed superior to the umbilicus and a similar port arrangement as for radical prostatectomy was used. We proceeded to the placement of bilateral nephrostomy; 6 weeks later we performed a robot-assisted bilateral ureteroneocystostomy according to an extra vesical Lich-Gregoir technique. Patient is supine, with a Trendelenburg position of 20°. The trocars are positioned as follows: robotic camera port, 5 cm above the umbilicus in the median line; two 8-mm robot ports, 8 cm laterally and caudally; and two 10-mm trocars for assistant, at level of the right iliac crest. An accessory 5-mm working port is placed in suprabuc area. We performed a bilateral vesico psoas-hitch and tension-free ureteral reimplantations on the bladder dome using running sutures. Pigtail catheters are placed retrogradely and the detrusor is closed over the ureters to create a submucosal tunnel. Results: The console time was 176 min. No intraoperative or postoperative complications were noticed and the estimate blood loss was 110 mL. The urethral catheter was removed after a cystogram showing no evidence of an anastomotic leakage on day 7, and the patient was discharged uneventfully from the hospital on day 9. The pigtails were removed after 3 weeks and the patients was asymptomatic after 2 months of follow-up. Conclusions: Laparoscopic reconstructive procedures may be performed for the management of mid and distal ureteric strictures, but difficulty with intra corporeal suturing and prolonged operative times remain distinct disadvantages. A bilateral ureteral reimplantation is more complex for anatomical and ergonomic reasons.3,4 With the added benefits of reduced hospital stay and improved patient quality of life, associated with minimally invasive surgery, the robot assistance is particularly well suited with superior visibility and ergonomics for the management of complex reconstructive procedures where a precise dissection and stitching is needed.5,6 The Endowrist® technology, and the Clutch function, will overcome the difficulties encountered in a pure laparoscopic approach. Bilateral robotic ureteroneocystostomy is a safe and effective treatment for the management of distal ureteric disease. We assure that we did not have any commercial associations during the last 2 years that might create a conflict of interest in connection with the published video. The authors have nothing to disclose. Runtime of video: 7 mins 02 secs

Thoracoscopic Basilar Segmentectomy

Port placement is described in Table 1 and Figure 1. This standardized port configuration can be used for all segmental resections. On the left, the port arrangement is shifted slightly posterior to account for the heart/mediastinum. A metal 10-mm port is introduced for the camera at the level of the 7th interspace in the midaxillary line. Instruments/staplers are introduced through the remaining incisions without ports, unless required. Rib spreading is avoided. 1 Schuchert M.J. Pettiford B.L. Pennathur A. et al. Anatomic segmentectomy for stage I non-small-cell lung cancer: Comparison of video-assisted thoracic surgery versus open approach. J Thorac Cardiovasc Surg. 2009; 138: 1318-1325 Abstract Full Text Full Text PDF PubMed Scopus (113) Google Scholar Table 1Port Placement Port Size, mm Intercostal Space # Anatomic Lines 1 (camera) 10 7th MA 2 10 7th PA 3 5 3rd MA Access incision 45 5th AA AA, anterior axillary; MA, mid-axillary; PA, posterior axillary. Open table in a new tab AA, anterior axillary; MA, mid-axillary; PA, posterior axillary.

Two-Port Laparoscopic Myomectomy Using 5mm-Flexible Scope

Single-port surgery causes relatively little stress to patients, and it has aesthetic advantages in that it leaves a small scar. On the other hand, it is stressful for the surgeon to perform, and because the surgical technique is limited by the constraints of the procedure, there is a risk that the quality of the surgery itself may be compromised. Uterine myomectomies, in particular, require complex suturing and more delicate manipulations than some other kinds of surgery. In an attempt to address these conditions, we developed a two-port surgery that would add one auxiliary port to the one usually used in single-port surgery. This report describes our actual experiences with applying this new technique to laparoscopic myomectomy. We also contrast the hemi-lateral and diamond port placement widely used in conventional surgery with the new port arrangement in our two-port technique, discussing their operability.

Chopstick surgery: a novel technique enables use of the Da Vinci Robot to perform single-incision laparoscopic surgery

Single-incision laparoscopic surgery (SILS) is limited by the coaxial arrangement of the instruments. A surgical robot with "wristed" instruments could overcome this limitation but the "arms" collide when working coaxially. This video demonstrates a new technique of "chopstick surgery," which enables use of the robotic arms through a single incision without collision. Experiments were conducted utilizing the da Vinci S® robot (Sunnyvale, CA) in a porcine model with three laparoscopic ports (12 mm, 2-5 mm) introduced through a single "incision." Pilot work conducted while performing Fundamentals of Laparoscopic Surgery (FLS) tasks determined the optimal setup for SILS to be a triangular port arrangement with 2-cm trocar distance and remote center at the abdominal wall. Using this setup, an experienced robotic surgeon performed a cholecystectomy and nephrectomy in a porcine model utilizing the "chopstick" technique. The chopstick arrangement crosses the instruments at the abdominal wall so that the right instrument is on the left side of the target and the left instrument on the right. This arrangement prevents collision of the external robotic arms. To correct for the change in handedness, the robotic console is instructed to drive the "left" instrument with the right hand effector and the "right" instrument with the left. Both procedures were satisfactorily completed with no external collision of the robotic arms, in acceptable times and with no technical complications. This is consistent with results obtained in the box trainer where the chopstick configuration enabled significantly improved times in all tasks and decreased number of errors and eliminated instrument collisions. Chopstick surgery significantly enhances the functionality of the surgical robot when working through a small single incision. This technique will enable surgeons to utilize the robot for SILS and possibly for intraluminal or transluminal surgery.

Single-port laparoscopic surgery with parallel procedures using direct puncture forceps

Single-port surgery utilizing a solitary incision at the umbilicus, but with multichannel access, improves cosmetic results. Initially, we grasp the lower umbilicus and edge of fascial defect together, using an Endopath XCEL 5.0 mm extra long (150.0 mm) sleeve as we optically puncture the fascia. The trocar tip is positioned 1.0 cm from the abdominal wall. A 30-degree 5.0 mm scope is then inserted through the central long trocar. Use of a clear central long trocar enables visualization of the two additional lateral trocars and Babcocks forceps that are subsequently inserted into the abdomen. The second and third punctures, each via Endopath XCEL 5.0 mm with long (100.0 mm) and short (75.0 mm) sleeves, are placed symmetrically 20.0 mm from the point at 5.0 mm closer to the focus from the camera port. We next insert Babcock forceps (5.0 mm diameter), without use of trochars, into the direct abdominal puncture along the inner detached opening. Insertion should be 10.0 mm from the camera port, oriented towards 12 o'clock. These forceps help maintain sufficient field of view. By implementing the above port arrangement, complete with direct puncture forceps, the need for trochars is reduced, thus promoting a safe single-port procedure.