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Hand-assisted laparoscopic devices: the second generation.

Rupa Patel1, Michael D Stifelman

  • 1Department of Urology, New York University School of Medicine, New York, New York 10016, USA.

Journal of Endourology
|December 16, 2004
PubMed
Summary
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The Gelport hand-assisted laparoscopic device significantly outperformed other first- and second-generation devices in a porcine model. This surgical tool shows promise for improving hand-assisted laparoscopic nephrectomy procedures.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Device Technology

Background:

  • Hand-assisted laparoscopic (HAL) nephrectomy is a growing surgical technique.
  • Three new second-generation hand-assist devices have been developed to enhance efficacy and usability.
  • Previous first-generation devices also exist for HAL procedures.

Purpose of the Study:

  • To prospectively evaluate and compare newly developed second-generation HAL devices against each other and against first-generation devices.
  • To assess the performance and user satisfaction of different HAL devices.

Main Methods:

  • 130 urologists performed HAL nephrectomies in a porcine laboratory setting.
  • Surgeons used either first-generation (Handport, Intromit, PneumoSleeve) or second-generation (Gelport, Omniport, LapDisc) devices.

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  • A 12-question survey was administered to evaluate device performance.

    • Main Results:

    • Gelport demonstrated statistically significant superiority over Omniport in all parameters and over LapDisc in 5 of 10 parameters.
    • Gelport was the only second-generation device to show significant improvement across all ratings compared to first-generation devices.
    • Gelport achieved high satisfaction scores (8.59 overall), while Omniport and LapDisc ratings were comparable to first-generation devices.

    Conclusions:

    • The Gelport device appears significantly superior to currently available hand-assist devices for HAL procedures.
    • Further clinical trials with larger patient cohorts are necessary to validate these findings in human subjects.