Introduction: Accidental thermal injuries are infrequent, nonetheless, dangerous complications in laparoscopic surgery. Burns are produced because of direct contact, lack of instrument insulation and capacitive coupling. Biological fluids on the surface of laparoscopic instruments behave as electric conductors on the sheath and may be responsible for accidental thermal injuries. Our hypothesis is that using an insulator device may prevent those injuries.
Materials And Methods: After evaluating different materials for dielectric properties, costs, and temperature increase tolerance, we selected polytetrafluoroethylene (PTFE) to develop a sleeve that works as an electrical insulator when applied on the sheath of laparoscopic instruments. Efficacy of this PTFE cover in reducing conduction of electricity was tested on both reusable and disposable laparoscopic instruments.
Results: Electric conduction of the laparoscopic instrument sheaths was tested using an ex vivo model that reproduces the abdominal environment in basal conditions and in presence of blood. Electric conduction of laparoscopic instruments was measured before and after the placement of the PTFE cover. We measured a significant difference in electric resistance on the sheath's surface without and with blood, revealing a weak electrical conduction: infinity versus a median value of 251.11 Mohm, respectively.
Conclusions: This ex vivo study demonstrated that a PTFE sleeve may reduce electricity conduction of laparoscopic instruments. A pilot in vivo study is planned to test its safety and efficacy.
Improved surgical skill is generally associated with improved patient outcomes, although assessment is subjective, labour intensive, and requires domain-specific expertise. Automated data-driven metrics can alleviate these difficulties, as demonstrated by existing machine learning instrument tracking models. However, these models are tested on limited datasets of laparoscopic surgery, with a focus on isolated tasks and robotic surgery.
Despite the benefits of minimally invasive surgery, interventions such as laparoscopic liver surgery present unique challenges, like the significant anatomical differences between preoperative images and intraoperative scenes due to pneumoperitoneum, patient pose, and organ manipulation by surgical instruments. To address these challenges, a method for intraoperative three-dimensional reconstruction of the surgical scene, including vessels and tumors, without altering the surgical workflow, is proposed. The technique combines neural radiance field reconstructions from tracked laparoscopic videos with ultrasound three-dimensional compounding.
Laparoscopic video tracking primarily focuses on two target types: surgical instruments and anatomy. The former could be used for skill assessment, while the latter is necessary for the projection of virtual overlays. Where instrument and anatomy tracking have often been considered two separate problems, in this article, a method is proposed for joint tracking of all structures simultaneously.
Objective: Aim: To evaluate the early postoperative results of surgical treatment of patients with inguinal hernias after laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP) using invasive and non-invasive methods of fixation of prosthetic material.
Patients And Methods: Materials and Methods: The study included 76 patients (average age 61,4±15,3 years; 69 [91 %] males, 7 [9 %] females) with primary uncomplicated unilateral inguinal hernias who underwent TAPP. Patients were divided into two groups: group 1 - 52 patients in whom the AbsorbaTack fixation device was used to secure the mesh; group 2 - 24 patients in whom the LiquiBand FIX8 cyanoacrylate adhesive was used.
The Senhance robotic system (Asensus Surgical, Durham, NC, USA) is an innovative platform for minimally invasive surgery. It enables surgeons to perform precise and cost-effective procedures using reusable instruments and has advanced features such as haptic feedback and eye-tracking camera control. Herein, we present the first application of the "double bipolar method" (DBM) in a Senhance-assisted laparoscopic partial cystectomy utilizing 3 mm Maryland bipolar instruments.
