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首页> 外文期刊>Surgical Endoscopy >New methods for innovation: the development of a toolbox for natural orifice translumenal endoscopic surgery (NOTES) procedures.
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New methods for innovation: the development of a toolbox for natural orifice translumenal endoscopic surgery (NOTES) procedures.

机译：创新的新方法：开发自然孔腔内窥镜手术（NOTES）程序的工具箱。

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Devices used for flexible intralumenal procedures are inadequate when used for intraperitoneal surgical procedures such as cholecystectomy.To assess/address limitations of flexible endoscopic devices in intraperitoneal surgery.To describe processes used to invent new devices to facilitate this new surgical genre.Engineering laboratory.None. INTERVENTIONS AND INVENTIONS: Reviews of the limitations of flexible endoscopic instruments and instrumentation/invention needs for a "NOTES cholecystectomy" were completed.The appropriateness of existing methods of device innovation was evaluated against an inventory of new technologies necessary to perform NOTES. The deficiencies in traditional innovation methods led to the creation of a novel process for invention of new medical devices: the "Inventorama."Cooperation between clinicians and industry to develop device concepts to enable NOTES.The devices included: (1) steerable flex trocar, (2) rotary access needle, (3) bipolar hemostasis forceps, (4) Maryland dissectors, (5) articulating hook knife, (6) rotating hook knife, (7) articulating graspers, (8) scissors, (9) ligating clip applier, and (10) tissue apposition system. Six of these ten were built and tested as initial crude prototypes in the Inventorama process; two underwent major modifications. Three were invented via alternate methods, including by independent clinicians.A new method for efficient medical device invention and development was created to address key technology needs for NOTES. The result was a "toolbox" of devices designed to address the key surgical activities necessary for advanced intralumenal and translumenal flexible endoscopic procedures.
机译：当用于腹腔内外科手术（例如胆囊切除术）时，用于腔内柔性手术的设备不足。评估/解决腹膜内手术中柔性内窥镜设备的局限性;描述用于发明新设备以促进这种新手术类型的工艺。工程实验室。 。干预和发明：完成了对柔性内窥镜器械的局限性和“ NOTES胆囊切除术”的器械/发明需求的审查。针对现有器械创新方法的适用性，根据执行NOTES所需的新技术进行了评估。传统创新方法的不足导致了发明新医疗设备的新方法的创造：“ Inventorama”。临床医生和业界之间的合作以开发设备概念以实现NOTES。这些设备包括：（1）可操纵的柔性套管针， （2）旋转式进针，（3）双极止血钳，（4）马里兰解剖器，（5）铰接弯刀，（6）旋转弯刀，（7）铰接式抓手，（8）剪刀，（9）结扎夹（10）组织并置系统。这十个中有六个是作为Inventorama工艺的原始原油原型制造并进行测试的;两项进行了重大修改。通过替代方法（包括独立的临床医生）发明了三项。创建了一种有效的医疗器械发明和开发的新方法，以满足NOTES的关键技术需求。结果是设计了一种设备的“工具箱”，以解决高级腔内和腔内柔性内窥镜手术所必需的关键外科手术活动。

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