Multipurpose internal retractor for Single-incision surgery (SIS): single-institution case series

Area of Science:

• Minimally Invasive Surgery
• Surgical Instrumentation

Background:

• Single-incision laparoscopic surgery (SIS) offers reduced invasiveness but presents significant technical challenges, including restricted instrument articulation and the absence of assistant ports.
• These limitations often hinder the widespread adoption and efficiency of SIS procedures.

Purpose of the Study:

• To introduce and evaluate a novel, self-sustaining, multipurpose internal retractor designed to mitigate the difficulties associated with single-incision laparoscopic surgery.
• To assess the safety, adaptability, and ease of use of this innovative retractor in a variety of SIS procedures.

Main Methods:

• Development of a unique internal retractor by integrating a Lone Star retractor hook with a laparoscopic bulldog clamp.
• Retrospective review of 104 patients undergoing SIS between October 2008 and April 2011 utilizing the novel retractor.
• Procedures included gastric banding, sleeve gastrectomies, cholecystectomies, and Nissen fundoplication.

Main Results:

• The novel internal retractor was successfully employed in 104 SIS cases without intraoperative complications related to its use.
• Minor adjustments for additional retraction were needed in 2 cases due to large liver size, indicating high adaptability.
• The retractor demonstrated safety, adaptability, and ease of use, effectively addressing key challenges in SIS.

Conclusions:

• The developed self-sustaining multipurpose internal retractor is a safe, adaptable, and user-friendly solution for single-incision laparoscopic surgery.
• This innovation helps overcome the inherent difficulties of SIS, potentially expanding its application and improving patient outcomes.