José Jorge da Silva1, Rafael Melo Silva1, Kárin Kneipp Costa1. 1. Departamento de Ginecologia e Obstetrícia e Departamento de Clínica Cirúrgica, Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
Abstract
BACKGROUND: Large number of surgical services use laparoscopy to approach the colon. One of the concerns on the resection using this way is the high rate of cancer relapse at in- and outlet site of the surgical instruments. AIM: To describe a protective device for surgical isolation in laparoscopic colectomy. METHODS: The device is made of sterile polyethylene plastic cover used to protect the fiber optic cable in laparoscopic surgery and one 20 Fr. urethral catheter working as a conduit. RESULTS: The device was used in six laparoscopic colectomies, three for adenocarcinoma of the colon and three for intestinal endometriosis. It was effective to avoid contact of the specimen with the abdominal wall, in order to reduce the risk of implantation of cancer or endometriotic cells and surgical site infection. The device was made intraoperative at all surgeries and allowed good visualization in laparoscopy and maintenance of the pneumoperitoneum. It cost R$ 22,00 (approximately US$ 10), R$14.50 related to the plastic cover and R$7.50, the urethral tube. The production time of the device and its installation in the abdominal cavity was measured in each procedure and was, on average, respectively, of 66 s and 25 s. CONCLUSION: The device proved to be feasible, not requiring any special training and can be performed by the surgical team itself, even at institutions with limited resources.
BACKGROUND: Large number of surgical services use laparoscopy to approach the colon. One of the concerns on the resection using this way is the high rate of cancer relapse at in- and outlet site of the surgical instruments. AIM: To describe a protective device for surgical isolation in laparoscopic colectomy. METHODS: The device is made of sterile polyethylene plastic cover used to protect the fiber optic cable in laparoscopic surgery and one 20 Fr. urethral catheter working as a conduit. RESULTS: The device was used in six laparoscopic colectomies, three for adenocarcinoma of the colon and three for intestinal endometriosis. It was effective to avoid contact of the specimen with the abdominal wall, in order to reduce the risk of implantation of cancer or endometriotic cells and surgical site infection. The device was made intraoperative at all surgeries and allowed good visualization in laparoscopy and maintenance of the pneumoperitoneum. It cost R$ 22,00 (approximately US$ 10), R$14.50 related to the plastic cover and R$7.50, the urethral tube. The production time of the device and its installation in the abdominal cavity was measured in each procedure and was, on average, respectively, of 66 s and 25 s. CONCLUSION: The device proved to be feasible, not requiring any special training and can be performed by the surgical team itself, even at institutions with limited resources.
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