KeyLoop: Mechanical Retraction of the Abdominal Wall for Gasless Laparoscopy

Area of Science:

• Surgical innovation
• Medical device engineering
• Global health equity

Background:

• Laparoscopic surgery offers benefits but faces implementation challenges in low- and middle-income countries (LMICs) due to supply shortages, cost, and power instability.
• Traditional insufflation methods are not always feasible in resource-limited environments.
• A mechanical alternative to pneumoperitoneum is needed to expand laparoscopic surgery access in LMICs.

Purpose of the Study:

• To design and evaluate a novel mechanical retractor system for laparoscopic surgery.
• To provide an alternative to gas insufflation in resource-limited settings.
• To ensure the retractor is anatomically optimized, structurally sound, and functionally effective.

Main Methods:

• Anatomical and mathematical optimization of a mechanical retractor design for abdominal wall retraction.
• Use of computed tomography data for anatomical definition and finite element analysis (FEA) for structural integrity assessment.
• Load testing and functional evaluation in a laparotomy model to assess displacement and field of view.

Main Results:

• A user guide and four sizes of the KeyLoop retractor were developed.
• FEA and load testing confirmed structural integrity with minimal displacement under simulated physiological loads.
• The retractor achieved a 57% larger field of view in a laparotomy model compared to an unretracted state.

Conclusions:

• The KeyLoop mechanical retractor is structurally sound, sterilizable, and manufacturable.
• It offers a viable alternative to traditional insufflation methods for laparoscopic surgery.
• The KeyLoop can enhance access to laparoscopic procedures for surgeons and patients in LMICs.