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Modified Marionette Technique for Laparoscopic Colorectal Surgery.

Seiichi Shinji1, Hayato Kan, Takeshi Yamada

  • 1Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School.

Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi
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Summary

The modified marionette technique offers an easy, safe, and effective solution for laparoscopic colorectal surgery. This method enhances instrument control and visualization, overcoming limitations of single-port access.

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Area of Science:

  • Surgical Innovation
  • Minimally Invasive Surgery

Background:

  • Single-port laparoscopic surgery presents challenges including limited instrument control, instrument collisions, and reduced range of motion.
  • These limitations can compromise surgical outcomes and surgeon experience.

Purpose of the Study:

  • To introduce and evaluate the "modified marionette technique" for laparoscopic colorectal surgery.
  • To address the technical limitations of single-port access surgery.

Main Methods:

  • The modified marionette technique utilizes an Internal Organ Retractor (IOR)™ and a specialized clip with 1-0 nylon thread.
  • Traction is achieved by externalizing the nylon thread through the abdominal wall via a looped thread and needle, allowing for precise adjustments.

Main Results:

  • The technique facilitates adequate traction and improved visualization during colorectal procedures.
  • It allows for precise placement adjustments of the retractor from outside the body.

Conclusions:

  • The modified marionette technique is an easy, economical, effective, and safe method for laparoscopic colorectal surgery.
  • This technique is beneficial for both reduced-port and multiport laparoscopic colorectal procedures.