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Functional and comparative evaluation of flexible monopolar endoscopic scissors.

E A Moran¹, J Bingener, C J Gostout

¹Developmental Endoscopy Unit, Charlton 8, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.

Surgical Endoscopy

|January 29, 2010

Summary

This study evaluated a flexible endoscopic scissors prototype, finding it effective for tissue biopsy, dissection, enterotomy, and suture cutting in natural orifice translumenal endoscopic procedures.

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Area of Science:

Minimally Invasive Surgery
Gastroenterology
Surgical Instrumentation

Background:

Natural orifice translumenal endoscopic procedures (NOTES) demand reliable tools for tissue dissection and suture cutting.
A flexible endoscopic scissors prototype was developed to meet these needs.

Purpose of the Study:

To evaluate the efficacy and safety of a novel flexible endoscopic scissors prototype.
To compare its performance in tissue dissection and enterotomy creation with traditional laparoscopic methods.

Main Methods:

An acute study in domestic swine utilized a flexible endoscopic scissors prototype (3.1 mm outer diameter) via a dual-channel colonoscope.
Procedures included peritoneal biopsies, gallbladder dissection with cautery, small bowel enterotomy, and suture cutting.

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Timed comparisons were made against laparoscopic shears for enterotomy creation.

Main Results:

The endoscopic scissors accurately performed tissue biopsies and suture cutting.
Cautery integration allowed for effective control of small vessels during gallbladder dissection.
Small bowel enterotomy creation took 4 minutes 54 seconds, compared to 1 minute 22 seconds laparoscopically.

Conclusions:

The flexible endoscopic scissors prototype is effective for various surgical tasks including biopsy, dissection, enterotomy, and suture cutting.
While effective, endoscopic enterotomy creation was less efficient than laparoscopy due to device and endoscope limitations.