Transanal access port (TrAAP) technique: the use of a single incision laparoscopic surgical port during canine colonoscopy (a cadaveric study)

Abstract Background Transanal colonoscopy using the single-incision laparoscopic surgical port is routinely used in human patients but has not been described in veterinary literature. The purpose of this study was to describe a novel access technique elucidating its endoscopic clinical potential and benefits. Additionally, its challenges, limitations, and clinical usability will be discussed and critiqued. The aim of this study was to describe the feasibility of the single-incision laparoscopic surgical port (SILS) as a transanal access technique in canine cadavers and compare its technical capabilities and economic value when compared to the traditional approaches of digital pressure and purse string. Results The overall time to reach an intraluminal pressure of 10 mmHg was faster for digital pressure versus purse string (p = 0.05) and faster for single-incision laparoscopic surgical port versus purse string (p < 0.02). Maximum luminal pressure was significantly higher between single-incision laparoscopic surgical port and purse string (p = 0.001). Mean pressure for both the complete 60 s trial and during the last 45 s of insufflation were highest with the SILS port and were significantly different between the single-incision laparoscopic surgical port versus purse string (p = 0.0001, p < 0.0001) and digital pressure versus purse string (p < 0.005, p < 0.01) respectively. Complete luminal distention and visualization was observed in all trials. Conclusions The SILS port in a cadaveric canine model allowed good visualization of the rectal and colonic mucosa, provided constant insufflation of the colon and was feasible and subjectively easy to perform. Technical differences between techniques were observed with the use of the SILS port allowing for potentially lower personnel requirements, less procedural associated cost, less variability versus the digital pressure technique between assistants, and the ability of additional instruments to be used for procedures.

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Maneuverability of the Scope and Instruments within Three Different Single-Incision Laparoscopic Ports: An Experimental Pilot Study

Animals ◽

10.3390/ani11051242 ◽

2021 ◽

Vol 11 (5) ◽

pp. 1242

Author(s):

Georg Haider ◽

Ursula Schulz ◽

Nikola Katic ◽

Christian Peham ◽

Gilles Dupré

Keyword(s):

Motion Analysis ◽

Single Incision ◽

Single Port ◽

Three Dimensional ◽

Analysis Software ◽

Port Access ◽

Port System ◽

Sils Port ◽

Glove Port ◽

Analysis System

Single-port access systems (SPASs) are currently used in human and veterinary surgeries. However, they pose technical challenges, such as instrument crowding, intra- and extracorporeal instrument collision, and reduced maneuverability. Studies comparing the maneuverability of the scopes and instruments in different SPASs are lacking. This study aimed to compare the maneuverability of three different SPASs: the Covidien SILS-port, Storz Endocone, and glove port. A clear acrylic box with artificial skin placed at the bottom was used to mimic the abdominal wall and cavity. The three SPASs were placed from below, and a 10-mm endoscope and 5-mm instrument were introduced. A motion analysis system consisting of 18 cameras and motion analysis software were used to track the movement of the endoscope and instrument, to determine the volume of the cone-shaped, three-dimensional figures over which movement was possible, with higher values indicating greater maneuverability. The Mann–Whitney U test was used for the analysis. The maneuverability of the endoscope alone was significantly higher in the glove port system than in the other two SPASs. When inserting an additional instrument, the maneuverability significantly decreased in the SILS-port and Endocone, but not in the glove port. The highest maneuverability overall was found in the glove port.

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Regeneration of Hypogastric Nerve Using a Polyglycolic Acid (PGA)-Collagen Nerve Conduit Filled with Collagen Sponge Proved Electrophysiologically in a Canine Model

The International Journal of Artificial Organs ◽

10.1177/039139880302600311 ◽

2003 ◽

Vol 26 (3) ◽

pp. 245-251 ◽

Cited By ~ 10

Author(s):

T. Ito ◽

T. Nakamura ◽

K. Suzuki ◽

T. Takagi ◽

T. Toba ◽

...

Keyword(s):

Canine Model ◽

Polyglycolic Acid ◽

Collagen Sponge ◽

Intraluminal Pressure ◽

Nerve Conduit ◽

Hypogastric Nerve ◽

Spermatic Duct ◽

New Type ◽

Conduit Diameter ◽

The Right

The hypogastric nerve (HGN) is a sympathetic nerve in the peritoneal cavity and controls urinary and seminal functions. In this study, the regeneration of HGN was determined by using a new type of an artificial nerve conduit, polyglycolic acid (PGA)-collagen nerve conduit filled with collagen sponge in two dogs. A PGA-collagen nerve conduit (diameter=2mm) was interposed in a 10 mm gap of the right HGN. The regeneration of the HGN was evaluated electrophysiologically 8 months after the operation. The intraluminal pressure of spermatic duct and the bladder neck were elevated 80 mmHg and 25 mmHg respectively by the stimulation across the regenerated HGN. The prostate contraction was also elicited. The responses diminished after the excision of the regenerated portion of HGN. These results proved the regeneration of HGN and this nerve conduit will be great help for patients who suffer from urinary and seminal disturbances.

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Robotic single-incision anterior resection for sigmoid colon cancer: access port creation and operative technique

Surgical Endoscopy ◽

10.1007/s00464-012-2549-0 ◽

2012 ◽

Vol 27 (3) ◽

pp. 1021-1021 ◽

Cited By ~ 18

Author(s):

Meng Shi Lim ◽

George Melich ◽

Byung Soh Min

Keyword(s):

Colon Cancer ◽

Sigmoid Colon ◽

Anterior Resection ◽

Operative Technique ◽

Single Incision ◽

Sigmoid Colon Cancer ◽

Access Port

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Transumbilical Gelport Access Technique for Performing Single Incision Laparoscopic Surgery (SILS)

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-008-0737-y ◽

2008 ◽

Vol 13 (1) ◽

pp. 159-162 ◽

Cited By ~ 158

Author(s):

Aziz M. Merchant ◽

Michael W. Cook ◽

Brent C. White ◽

S. Scott Davis ◽

John F. Sweeney ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Single Incision ◽

Single Incision Laparoscopic Surgery ◽

Access Technique

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Single-Incision Transumbilical Laparoscopic Right Hemicolectomy Using SILS Port™

The American Surgeon ◽

10.1177/000313481107700242 ◽

2011 ◽

Vol 77 (2) ◽

pp. 252-253

Author(s):

Alan A. Saber ◽

Tarek H. El-Ghazaly

Keyword(s):

Single Incision ◽

Right Hemicolectomy ◽

Sils Port ◽

Laparoscopic Right Hemicolectomy

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Motility and intraluminal pressure of the ileocolonic junctional zone and adjacent bowel in a canine model

Urological Research ◽

10.1007/bf00296830 ◽

1993 ◽

Vol 21 (5) ◽

pp. 329-332 ◽

Cited By ~ 7

Author(s):

Rainer Hofmann ◽

Reynaldo Gomez ◽

Emil A. Tanagho ◽

Jack W. McAninch

Keyword(s):

Canine Model ◽

Intraluminal Pressure ◽

Junctional Zone

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Single-incision thoracoscopic surgery for primary spontaneous pneumothorax using the SILS port compared with conventional three-port surgery

Surgical Endoscopy ◽

10.1007/s00464-012-2381-6 ◽

2012 ◽

Vol 27 (1) ◽

pp. 139-145 ◽

Cited By ~ 43

Author(s):

Hee Chul Yang ◽

Sukki Cho ◽

Sanghoon Jheon

Keyword(s):

Spontaneous Pneumothorax ◽

Single Incision ◽

Thoracoscopic Surgery ◽

Primary Spontaneous Pneumothorax ◽

Sils Port

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First Canadian experience with robotic single-incision pyeloplasty: Comparison with multi-incision technique

Canadian Urological Association Journal ◽

10.5489/cuaj.3440 ◽

2016 ◽

Vol 10 (3-4) ◽

pp. 83 ◽

Cited By ~ 5

Author(s):

Jeffrey Law ◽

Neal Rowe ◽

Jason Archambault ◽

Sofia Nastis ◽

Alp Sener ◽

...

Keyword(s):

Single Incision ◽

Single Port ◽

Operating Time ◽

Length Of Hospital Stay ◽

Success Rates ◽

Access Port ◽

Significant Difference ◽

Site Access ◽

Da Vinci Robotic System ◽

Incision Technique

Introduction: We compared the outcomes of single-incision, robotassisted laparoscopic pyeloplasty vs. multiple-incision pyeloplasty using the da Vinci robotic system.Methods: We reviewed all consecutive robotic pyeloplasties by a single surgeon from January 2011 to August 2015. A total of 30 procedures were performed (16 single:14 multi-port). Two different single-port devices were compared: the GelPort (Applied Medical, Rancho Santa Margarita, CA) and the Intuitive single-site access port (Intuitive Surgical, Sunnyvale, CA).Results: Patient demographics were similar between the two groups. Mean operating time was similar among the single and multi-port groups (225.2 min vs. 198.9 minutes [p=0.33]). There was no significant difference in length of hospital stay in either group (86.2 hr vs. 93.2 hr [p=0.76]). There was no difference in success rates or postoperative complications among groups.Conclusions: Single-port robotic pyeloplasty is non-inferior to multiple-incision robotic surgery in terms of operative times, hospitalization time, success rates, and complications. Verifying these results with larger cohorts is required prior to the wide adoption of this technique. Ongoing objective measurements of cosmesis and patient satisfaction are being evaluated.

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