Instrumentation for laparoscopic renal surgery--Padron Endoscopic Exposing Retractor (PEER) and Endoholder: point of technique.
Identifieur interne : 001991 ( PubMed/Corpus ); précédent : 001990; suivant : 001992Instrumentation for laparoscopic renal surgery--Padron Endoscopic Exposing Retractor (PEER) and Endoholder: point of technique.
Auteurs : Jamil Rehman ; Chandru P. Sundaram ; Sardar A. Khan ; Ramakrishna Venkatesh ; Wayne C. WaltzerSource :
- Surgical laparoscopy, endoscopy & percutaneous techniques [ 1530-4515 ] ; 2005.
English descriptors
- KwdEn :
- MESH :
- instrumentation : Adrenalectomy, Nephrectomy.
- methods : Laparoscopy.
- standards : Laparoscopes, Surgical Instruments.
- Equipment Design, Humans.
Abstract
During laparoscopic surgery, as in open surgery, exposure is critical. However, this can be difficult during laparoscopy due to limited haptic feedback and the loss of 3-dimensional visualization. Excessive force may be inadvertently applied by assistants when anatomic structures are retracted; similarly, the retractors may be unknowingly moved because the limited field of view with the laparoscope precludes constant visualization of the retracting instrument. To overcome these problems, we have been using a 5- or 10-mm PEER retractor in combination with an articulating arm instrument holder (Endoholder) to aid laparoscopic renal surgery. The adjustable spring-loaded articulating instrument holder (Endoholder) consists of 4 components, including table attachment, a base rod, flexible extension arm, and precision clamp. The clamp accommodates variously sized instruments, and the flexible extension arm rotates 360 degrees to aid in positioning. The instrument holder is clamped to the table via the base rod over a sterile drape. A PEER Retractor, Roto-lok ratchet (5- or 10-mm diameter and 32-cm length) is placed intracorporeally to retract and position the kidney for hilar, upper, and lower pole dissection. The PEER retractor's handle is secured in place using the precision clamp of the instrument holder. The articulating instrument holder and PEER retractor are used for our renal, adrenal, and ureteral laparoscopic procedures. Placement of the retractor through a 5- or 10-mm port and deployment can be done quickly. Adequate and stable positioning of the retractor provides excellent and secure visualization of the operative field. These instruments have been used in more than 200 cases without any complication except 1 minor liver laceration. The articulating instrument holder with the PEER retractor is a very useful aid during laparoscopic renal surgery. This instrument reduces the chances of inadvertent injury to viscera by the assistant while maintaining an excellent anatomic view throughout the procedure. This will have a significant impact on the advancement of laparoscopy and its acceptance by every urologist.
PubMed: 15714150
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Khan</name></author><author><name sortKey="Venkatesh, Ramakrishna" sort="Venkatesh, Ramakrishna" uniqKey="Venkatesh R" first="Ramakrishna" last="Venkatesh">Ramakrishna Venkatesh</name></author><author><name sortKey="Waltzer, Wayne C" sort="Waltzer, Wayne C" uniqKey="Waltzer W" first="Wayne C" last="Waltzer">Wayne C. Waltzer</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2005">2005</date><idno type="RBID">pubmed:15714150</idno><idno type="pmid">15714150</idno><idno type="wicri:Area/PubMed/Corpus">001991</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Instrumentation for laparoscopic renal surgery--Padron Endoscopic Exposing Retractor (PEER) and Endoholder: point of technique.</title><author><name sortKey="Rehman, Jamil" sort="Rehman, Jamil" uniqKey="Rehman J" first="Jamil" last="Rehman">Jamil Rehman</name><affiliation><nlm:affiliation>Department of Urology, School of Medicine, SUNY-Stony Brook University Health Sciences Center, Stony Brook, NY 11794-8093, USA. jarehman@notes.cc.sunysb.edu</nlm:affiliation></affiliation></author><author><name sortKey="Sundaram, Chandru P" sort="Sundaram, Chandru P" uniqKey="Sundaram C" first="Chandru P" last="Sundaram">Chandru P. Sundaram</name></author><author><name sortKey="Khan, Sardar A" sort="Khan, Sardar A" uniqKey="Khan S" first="Sardar A" last="Khan">Sardar A. Khan</name></author><author><name sortKey="Venkatesh, Ramakrishna" sort="Venkatesh, Ramakrishna" uniqKey="Venkatesh R" first="Ramakrishna" last="Venkatesh">Ramakrishna Venkatesh</name></author><author><name sortKey="Waltzer, Wayne C" sort="Waltzer, Wayne C" uniqKey="Waltzer W" first="Wayne C" last="Waltzer">Wayne C. Waltzer</name></author></analytic><series><title level="j">Surgical laparoscopy, endoscopy & percutaneous techniques</title><idno type="ISSN">1530-4515</idno><imprint><date when="2005" type="published">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adrenalectomy (instrumentation)</term><term>Equipment Design</term><term>Humans</term><term>Laparoscopes (standards)</term><term>Laparoscopy (methods)</term><term>Nephrectomy (instrumentation)</term><term>Surgical Instruments (standards)</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Adrenalectomy</term><term>Nephrectomy</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Laparoscopy</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Laparoscopes</term><term>Surgical Instruments</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Equipment Design</term><term>Humans</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">During laparoscopic surgery, as in open surgery, exposure is critical. However, this can be difficult during laparoscopy due to limited haptic feedback and the loss of 3-dimensional visualization. Excessive force may be inadvertently applied by assistants when anatomic structures are retracted; similarly, the retractors may be unknowingly moved because the limited field of view with the laparoscope precludes constant visualization of the retracting instrument. To overcome these problems, we have been using a 5- or 10-mm PEER retractor in combination with an articulating arm instrument holder (Endoholder) to aid laparoscopic renal surgery. The adjustable spring-loaded articulating instrument holder (Endoholder) consists of 4 components, including table attachment, a base rod, flexible extension arm, and precision clamp. The clamp accommodates variously sized instruments, and the flexible extension arm rotates 360 degrees to aid in positioning. The instrument holder is clamped to the table via the base rod over a sterile drape. A PEER Retractor, Roto-lok ratchet (5- or 10-mm diameter and 32-cm length) is placed intracorporeally to retract and position the kidney for hilar, upper, and lower pole dissection. The PEER retractor's handle is secured in place using the precision clamp of the instrument holder. The articulating instrument holder and PEER retractor are used for our renal, adrenal, and ureteral laparoscopic procedures. Placement of the retractor through a 5- or 10-mm port and deployment can be done quickly. Adequate and stable positioning of the retractor provides excellent and secure visualization of the operative field. These instruments have been used in more than 200 cases without any complication except 1 minor liver laceration. The articulating instrument holder with the PEER retractor is a very useful aid during laparoscopic renal surgery. This instrument reduces the chances of inadvertent injury to viscera by the assistant while maintaining an excellent anatomic view throughout the procedure. This will have a significant impact on the advancement of laparoscopy and its acceptance by every urologist.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">15714150</PMID><DateCreated><Year>2005</Year><Month>02</Month><Day>16</Day></DateCreated><DateCompleted><Year>2005</Year><Month>05</Month><Day>24</Day></DateCompleted><DateRevised><Year>2006</Year><Month>11</Month><Day>15</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1530-4515</ISSN><JournalIssue CitedMedium="Print"><Volume>15</Volume><Issue>1</Issue><PubDate><Year>2005</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Surgical laparoscopy, endoscopy & percutaneous techniques</Title><ISOAbbreviation>Surg Laparosc Endosc Percutan Tech</ISOAbbreviation></Journal><ArticleTitle>Instrumentation for laparoscopic renal surgery--Padron Endoscopic Exposing Retractor (PEER) and Endoholder: point of technique.</ArticleTitle><Pagination><MedlinePgn>18-21</MedlinePgn></Pagination><Abstract><AbstractText>During laparoscopic surgery, as in open surgery, exposure is critical. However, this can be difficult during laparoscopy due to limited haptic feedback and the loss of 3-dimensional visualization. Excessive force may be inadvertently applied by assistants when anatomic structures are retracted; similarly, the retractors may be unknowingly moved because the limited field of view with the laparoscope precludes constant visualization of the retracting instrument. To overcome these problems, we have been using a 5- or 10-mm PEER retractor in combination with an articulating arm instrument holder (Endoholder) to aid laparoscopic renal surgery. The adjustable spring-loaded articulating instrument holder (Endoholder) consists of 4 components, including table attachment, a base rod, flexible extension arm, and precision clamp. The clamp accommodates variously sized instruments, and the flexible extension arm rotates 360 degrees to aid in positioning. The instrument holder is clamped to the table via the base rod over a sterile drape. A PEER Retractor, Roto-lok ratchet (5- or 10-mm diameter and 32-cm length) is placed intracorporeally to retract and position the kidney for hilar, upper, and lower pole dissection. The PEER retractor's handle is secured in place using the precision clamp of the instrument holder. The articulating instrument holder and PEER retractor are used for our renal, adrenal, and ureteral laparoscopic procedures. Placement of the retractor through a 5- or 10-mm port and deployment can be done quickly. Adequate and stable positioning of the retractor provides excellent and secure visualization of the operative field. These instruments have been used in more than 200 cases without any complication except 1 minor liver laceration. The articulating instrument holder with the PEER retractor is a very useful aid during laparoscopic renal surgery. This instrument reduces the chances of inadvertent injury to viscera by the assistant while maintaining an excellent anatomic view throughout the procedure. This will have a significant impact on the advancement of laparoscopy and its acceptance by every urologist.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rehman</LastName><ForeName>Jamil</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Urology, School of Medicine, SUNY-Stony Brook University Health Sciences Center, Stony Brook, NY 11794-8093, USA. jarehman@notes.cc.sunysb.edu</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sundaram</LastName><ForeName>Chandru P</ForeName><Initials>CP</Initials></Author><Author ValidYN="Y"><LastName>Khan</LastName><ForeName>Sardar A</ForeName><Initials>SA</Initials></Author><Author ValidYN="Y"><LastName>Venkatesh</LastName><ForeName>Ramakrishna</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Waltzer</LastName><ForeName>Wayne C</ForeName><Initials>WC</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016427">Technical Report</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Surg Laparosc Endosc Percutan Tech</MedlineTA><NlmUniqueID>100888751</NlmUniqueID><ISSNLinking>1530-4515</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000315">Adrenalectomy</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000295">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D004867">Equipment Design</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D020706">Laparoscopes</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000592">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010535">Laparoscopy</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D009392">Nephrectomy</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000295">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013525">Surgical Instruments</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000592">standards</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2005</Year><Month>2</Month><Day>17</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2005</Year><Month>5</Month><Day>25</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2005</Year><Month>2</Month><Day>17</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pii">00129689-200502000-00004</ArticleId><ArticleId IdType="pubmed">15714150</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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