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Single Port Laparoscopic Surgery - "LESS" or "SILS"

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19/02/2009




The ASC TriPort is a multi-instrument access port for laparoscopic surgery which is usually deployed through the umbilicus or any proposed stoma site 

It allows the surgeon to use up to 3 operating instruments and one camera; all used simultaneously through the single incision.  There are two 5mm ports and one 12mm port. 

It comes with an introducer. 

Cost for 5 Triports £ 1,521.76 with VAT















Getting started:

Incise and mobilise the umbilicus (infra-umbilical) and underlying peritoneum

Insert the folded ring of the triport into the introducer as shown below



Use the introducer to insert the distal ring into the peritoneal cavity then push the introducer thumb switch to eject the distal ring (shown below).




Remove the introducer and pull up the sleeve untill the inner ring snugs-up against the abdominal wall.



Push down the outer ring and triport whilst pulling up the outer sleeve



Remove excess sleeve and pull-up the excess slack of the removal ribbon/ring

Attach the insuflatioin tube and start to operate.  We use a 5mm 30 degree laparoscope with integrated light cable.  Ordinary laparoscopes/light leads interfere too much with the instrumentation.  It is advisable to lubricate the silica gell operating ports and to lubricate the intruments.




At first there is a tendancy to hold all the instrument close together.  Remember, the ports can move and that you can seperate your hands! 

Here we are seen using an Autonomy™ Laparo-Angle™ hook dissector from Cambridge Endo. The unique, articulating tips offer seven degrees of freedom for access to difficult areas and for tip positioning and control. 

They take about 15minutes to get comfortable with

Distal Tip Bends Upward or Downward When Maneuvering the Handle Upward or Downward

Tip Turns 360° at Any Angle When Turning Axial Rotation Knob in Handle

Distal Tip Bends Sideways When Maneuvering Handle Sideways

allows 7 degrees of freedom for access to difficult areas and for tip positioning
hand motions are mapped with full articulation
tip rotates 360° around its axis at any angle

 

At the end of the procedure remove the port by pulling on the ringed ribbon (pulls out the maleable internal ring of the port) and then close the incision. 

If your TAP block is working your patient will be able to eat their lunch and go home in a few hours.  Perhaps even have a curry and a few drinks!  The recovery is remarkable.




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Unit 4 Sunnybank Centre, Upper Dargle Road

Bray, Co Wicklow

Ireland
phone: 00 353 1 2864777
Fax: 00 353 1 286 4776


email: info@advancedsurgical.ie



Elemental Healthcare Ltd
Shefford Park Farm
Great Shefford
Nr Hungerford
Berkshire
RG17 7ED

Tel: 0844 412 0020
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Email: info@elementalhealthcare.co.uk

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SPIRE Hospital, Bristol. 
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