Avoiding risks and accidents during first abdominal entry for laparoscopic/robotic surgery скачать в хорошем качестве

Avoiding risks and accidents during first abdominal entry for laparoscopic/robotic surgery

Conventional technology and methods of laparoscopic/robotic abdominal entry are highly effective and safe. Nevertheless, in human hands, entry accidents are inevitable. 3 pitfalls during entry: a) patient variables of age, sex, body habitus, and surgeon background and experience b) sharp/pointed instruments c) 'past-pointing' occurs when the tip of the entry instrument is advanced past the intended endpoint, causing inadvertent tissue injury. Novel/alternative method of safe abdominal entry: A bluntly configured, hollow 3 mm skin punch disrupts the low-pressure seal of the peritoneal cavity, allowing rapid/instantaneous pressure equalization as gas flows naturally from high to low pressure. The skin punch is rendered harmless at the instant that the blunt tip breaches the peritoneum; risk of 'past-pointing' is eliminated Fascial dilation allows the surgeon to insert the trocar system without force (effortless trocar insertion into a 'safety bubble'). Entry accidents are best avoided by employing a pre-emptive strategy: no sharp/pointed instruments in the operative field until 'fail-safe' conditions are in place. Blunt tipped, hollow instrument for entry into the peritoneum eliminates past-pointing and inadvertent tissue injury. Efflortless trocar insertion eliminates variables attributed to patient age, sex, body habitus and surgeon background and experience.