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Hydrophilic guide wire technique to facilitate organ entrapment using a laparoscopic sack during laparoscopy
Chandru P Sundaram1, Yoshinari Ono, Jaime Landman
1Division of Urologic Surgery and Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
Purpose:
Morcellation of the kidney in a LapSac (Cook Surgical, Spencer, Indiana) is reportedly safe and effective during laparoscopic nephrectomy. However, organ entrapment in a LapSac can be difficult, especially during early surgeon experience. A technique to facilitate organ entrapment is described.
Materials And Methods:
We have recently used a simple technique to facilitate deployment of the LapSac in the abdomen using a hydrophilic nitinol guide wire passed through the holes in the mouth of the sack beside its drawstring. The inherent elasticity of the guide wire helps to spring open the mouth of the sack, while facilitating appropriate orientation of the sack mouth.
Results:
This technique appears to decrease the time needed for organ entrapment because it eliminates the need to triangulate the sack to achieve organ entrapment. An additional port is usually not required during the procedure.
Conclusions:
The hydrophilic guide wire technique is inexpensive and effective for LapSac deployment and organ entrapment.