Minimally Invasive Surgery: New Devices of Interest

The latest devices and gadgetry for minimally invasive gynecological surgery were featured in the exhibit hall at the 42nd AAGL Global Congress on Minimally Invasive Gynecology held just outside of Washington, DC, November 10-14, 2013. According to an informal poll, laparoscopic surgeons tend to favor using the equipment on which they were trained. For the curious, however, the following devices seemed to generate the most interest from the hundreds of Ob/Gyn conference attendees from around the world.

Articulating HD 3D Laparoscopic Surgical Video System

This new technology restores natural 3D vision and depth perception when performing laparoscopic procedures. When used in conjunction with the EndoEye Flex 3D, this system is reported to improve speed, accuracy, and precision of surgical tasks, such as dissection, grasping, and suturing, when compared with traditional 2D surgical systems. However, the viewing mode can be easily switched between 2D and 3D from the surgical field, depending on the surgeon’s preferences. (Olympus)

 EndoEye Flex 3D 

This aforementioned fully autoclavable, 5-mm HD videoscope has an articulating tip that can bend in all directions up to 100 degress. The all-in-one design integrates the light cable and camera system into the laparoscope for improved ergonomics and easier set up, and the “camera” is near the tip of the instrument, which enables bright, clear images and eliminates the need for manual focusing. In addition, narrow band imaging enhances visualization of vessels and other mucosal surface tissues and is always available in both 2D and 3D viewing modes. (Olympus) 

AIR SEAL

This system allows for stable pneumoperitoneum, even under constant suction, and provides continuous smoke evacuation throughout the entire procedure. According to the manufacturer, slight changes in intra-abdominal pressure are detected by the real-time sensing capabilities of the Intelligent Flow System, and flow adjustments are made instantaneously, either sending more gas into the cavity or allowing it to vent out. The system also allows for constant, valve-free access to the abdominal cavity and is reported to reduce operative time as well as patient carbon dioxide absorption. (SurgiQuest, Inc.)

Symphion Hysteroscopic Morcellation System*

The Symphion System is designed for endoscopically controlled radiofrequency bipolar resection and removal of soft tissue, such as polyps and myomas, that requires endoscopic visualization under continuous flow conditions. The system volumetrically limits the maximum saline intravasation to 2.5 liters or less and offers a user-activated continuous flow fluid management to quickly provide clear visualization. The system also is reported to directly control intrauterine pressure to prevent uterine collapse during surgical procedures. *Not FDA approved

THUNDERBEAT Advanced Energy Platform

THUNDERBEAT combines advanced bipolar and ultrasonic energies into a single multifunctional hand instrument that allows surgeons to simultaneously seal and cut vessels 7 mm or smaller with minimal thermal spread. The device reportedly delivers reliable vessel sealing and provides the highest grasping forces at the tip compared with similar energy instruments currently available. In addition, THUNDERBEAT, when combined with an electrosurgical generator, can deliver monopolar, bipolar, ultrasonic, and advanced bipolar energy, as well as combine advanced bipolar and ultrasonic energies in a single instrument. (Olympus)

ENSEAL® G2 Articulating Tissue Sealers

This single-use surgical instrument is the first articulating advanced energy device that allows surgeons to take a perpendicular approach to cut and seal vessels up to 7 millimeters in diameter and lymphatics through a 5-millimeter port. Key features, according to the manufacturer, are 110-degree articulation, 360-degree rotating shaft, 3-mm curved and 5-mm straight jaw types, and 35-centimeter and 45-centimeter shaft lengths (from jaw tip to rotation knob). (Ethicon)

SutureEase

This device enables reliable closure of the trocor site by using a unique “snare guide” technology in combination with a safety enhanced suture passer. (Securus)

Full da Vinci® Si HD Surgical System

©2014 Intuitive Surgical, Inc

This da Vinci® System features a magnified 3D HD vision system and special wristed instruments that bend and rotate far greater than the human wrist. Therefore, this robotic surgical system allows for performing complex surgery with enhanced vision, precision, dexterity, and control.
(Intuitive Surgical, Inc)