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首页> 外文会议>ASME(American Society of Mechanical Engineers) International Mechanical Engineering Congress: Advances in Bioengineering; 20031115-20031121; Washington,DC; US >DEVELOPMENT OF A TRANSABDOMINAL ANCHORING SYSTEM FOR TROCAR-LESS LAPAROSCOPIC SURGERY
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DEVELOPMENT OF A TRANSABDOMINAL ANCHORING SYSTEM FOR TROCAR-LESS LAPAROSCOPIC SURGERY

机译：无腹腔镜腹腔镜手术经腹固定系统的开发

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Compared with open surgery, laparoscopy results in significantly less pain, faster convalescence, and less morbidity. However, eye-hand dissociation, a two-dimensional field-of-view and fixed instrumentation with limited degrees of freedom contribute to a steep learning curve and demanding dexterity requirements for many laparoscopic procedures. One of the main limitations of laparoscopy is the fixed working envelope surrounding each trocar, often necessitating placement of multiple ports to accommodate changes in position of the instruments or laparoscope to improve visibility and efficiency. The placement of additional working ports contributes to post-operative pain and carries a small risk of bleeding or adjacent organ damage. In order to provide for greater flexibility of endoscopic viewing and instrument usage and to further reduce morbidity, a novel adjunct laparoscopic system has been developed consisting of a platform capable of supporting various laparoscopic tools which is secured magnetically to the abdominal wall and subsequently positioned within the abdominal cavity through surgeon-controlled, external magnetic couples on the patient's abdomen. Using this technique, instruments such as miniature endoscopic cameras used to augment the surgical field of view and surgical retractors have been successfully evaluated in a dry laboratory as well as in porcine models, with several others currently under investigation. This document elaborates on the theoretical and empirical process which has led to anchoring designs optimized for size, strength and surgical compatibility, as well as the benefits, limitations and prospects for the use of incisionless, magnetically-coupled tooling in laparoscopic surgery.
机译：与开放式手术相比，腹腔镜检查可显着减少疼痛，恢复更快并减少发病率。但是，眼手分离，二维视野和具有有限自由度的固定仪器会导致陡峭的学习曲线，并导致许多腹腔镜手术的灵活性要求更高。腹腔镜检查的主要局限性之一是固定在每个套管针周围的工作范围，通常需要放置多个端口以适应器械或腹腔镜的位置变化，从而提高可见度和效率。放置额外的工作端口会增加术后疼痛，并且出血或邻近器官受损的风险很小。为了提供更大的内窥镜观察和器械使用灵活性，并进一步降低发病率，已开发了一种新型辅助腹腔镜系统，该系统包括一个能够支撑各种腹腔镜工具的平台，该平台通过磁力固定在腹壁并随后定位在腹腔镜内。通过外科医生在患者腹部上控制的外部磁偶将腹腔置于腹部。使用这种技术，已在干燥实验室以及猪模型中成功评估了用于扩大手术视野的仪器（例如微型内窥镜相机和手术牵开器），目前正在研究其他几种方法。该文件详细介绍了理论和经验过程，这些过程已导致针对尺寸，强度和手术兼容性进行优化的锚固设计，以及在腹腔镜手术中使用无切口电磁耦合工具的好处，局限性和前景。

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