Surgeon performs single-port laparoscopic surgery > Kidney removal with instruments inserted through single port access SPA > One Port Umbilicus Surgery OPUS > Uretero-pelvic junction repair > Bilateral pyeloplasty > Triport > Quadport > R-Port laparoscopic access device > Advanced Surgical Concepts ASC

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Is trans-umbilical single-port, scar-free surgery the next major advance in laparoscopic surgery? How many of the four million laparoscopic surgical procedures each year will convert to the OPUS laparoscopic surgical procedure that eliminates post-surgical scars? Is single port access SPA laparoscopy positioned to be more successful than using the natural orifice transluminal endoscopic surgery (NOTES) approach to perform cholecystectomy and nephrectomy?

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The ASC R-Port Laparoscopic Access Device (ASC R-Port) is a laparoscopic instrument access port that is used to perform the same function as a standard trocar. The ASC R-Port is offered with four different Introducer components which can be used to deploy the ASC R-Port. The surgeon will select the appropriate Introducer based on whether the first ASC R-Port, second or subsequent ASC R-Port is being introduced and the size of the instruments to be passed through the ASC R-Port.

The ASC R-Port is a sterile, latex-free, disposable laparoscopic instrument port which performs two functions as follows:

It retracts a small abdominal incision to allow laparoscopic instruments pass through to the abdomen

It ensures that pneumoperitoneum is maintained in the abdomen during the surgical procedure whether or not a laparoscopic instrument is passing through the port.

The ASC R-Port is comprised of the following:

a retracting portion which retracts an abdominal incision to allow the passage of laparoscopic instruments

a valve portion which maintains the pneumoperitoneum established for the surgical procedure.

Deployment of the first ASC R-Port is accomplished using a Hasson cut-down incision. This is also common practice for the deployment of a first trocar. Deployment of the second and subsequent ASC R-Ports is very similar to the deployment of standard trocars in that the incision is created by a bladeless dissecting-tipped introducer which is removed following creation of the abdominal incision…

The ASC R-Port provides an access path for laparoscopic instruments through a small incision in the abdominal wall very similar to the function of the predicate trocars. A standard trocar consists of a bladeless dissecting-tipped component for creating a small incision in an abdominal wall, and a rigid cannula which keeps the small incision open, thereby providing an access path for laparoscopic instruments through the small incision in the abdominal wall. To deploy a trocar, a skin incision is created at the desired location in the patient’s abdomen. The trocar creates its own incision through to the abdomen using its bladeless dissecting-tipped member which is rotated back and forth as it is advanced through the tissue layers. Once it has penetrated through to the abdomen, the bladeless dissecting-tipped member is removed, leaving the rigid cannula through which the laparoscopic instruments can be introduced. There is a valve system on the trocar to maintain pneumoperitoneum, whether an instrument is present in the trocar or not…

The first ASC R-Port is deployed via a Hasson cut-down incision which is created at the desired location in the patient’s abdomen. The ASC R-Port is delivered through this incision with a blunt “Hasson Hook Introducer”. The second and subsequent ASC R-Ports are deployed via a skin incision created at the desired location in the patient’s abdomen. The ASC R-Port is mounted to the relevant bladeless dissecting – tipped introducer (Injector Introducer or 5mm Hook Introducer or 12mm hook Introducer). The bladeless dissecting-tipped introducer creates its own incision through to the abdomen by rotating it back and forth as it is advanced through the tissue layers. Once it has penetrated through to the abdomen, the distal ring of the ASC R-Port is separated from the bladeless dissecting-tipped member. The bladeless dissecting-tipped member is now removed from the incision.

When the ASC R-Port is deployed, the Distal Ring and the Outer Proximal Ring are drawn as close together as the abdominal wall will allow. This sets up tension in the Retracting Sleeve between these two rings, and it is this tension that opens the incision and creates an access path for laparoscopic instruments. There is a valve system on the ASC R-Port to maintain pneumoperitoneum, whether an instrument is present in the ASC R-Port or not…

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