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Highlights in Laparoscopic Surgery

Laparoscopy in Surgery, Gynecology, and Urology

The New Trocar Generation from KARL STORZ

The new trocar generation combines single-use and reusable components. In line with the KARL STORZ company philosophy, the cannulas and trocars were designed with reusable components in mind. The valve seal is intended for single use.

Special Features:

  • Ergonomic shape of the trocar ensures safe and comfortable handling during placement of the trocar
  • One-piece sealing system for single use (package of 10)
  • Minimal friction between the valve seal and the instrument
  • Considerably reduced weight and good balance thanks to the newly designed plastic trocar housing
  • Color coding for clear identification of different sizes
  • Available in the sizes 2.5 mm – 13.5 mm

New Flexible Trocar Generation

The new trocar generation from KARL STORZ has been expanded to include flexible trocars for use with curved instruments. The flexible trocar system is available in two sizes (6 mm and 11 mm) and with two different trocar types (pyramidal and conical-blunt).

Special Features:

  • Flexible cannulas for use with curved operating instruments
  • Can be combined with ROTATIP® instruments with jaw and sheath rotation
  • Ergonomic shape of the trocar ensures safe and comfortable handling during placement of the trocar
  • One-piece sealing system for single use
  • Minimal friction between the valve seal and the instrument
  • Color coding for clear identification of different sizes

Fluorescence Imaging

The near-infrared (NIR/ICG) system from KARL STORZ provides visualization beyond the tissue surface. Near-infrared (NIR) technology makes it possible to visualize the distribution of the fluorescent contrast agent indocyanine green (ICG), which enables enhanced visualization of anatomical structures such as the biliary ducts, the lymphatic system and blood vessels.

Special Features:

  • Fluorescence mode with background illumination
  • Rapid switchover via footswitch between white light and ICG modes
  • Telescopes for endoscopic and open surgical interventions (VITOM®)
  • In addition to 10 mm telescopes, telescopes with a diameter of 5 mm (0° and 30°) are also available now
  • Optimal illumination and contrast enhancement thanks to the IMAGE1 S camera platform
Blood perfusion assessment of colon section in a colorectal cancer patient
Blood perfusion assessment of colon section in a colorectal cancer patient – Source: Prof. Luigi Boni, University of Insubria, Varese, Italy

Perfusion assessment plays an important role in various medical specialties. Ischemic areas can be easily identified by using the NIR/ICG system and administering ICG. This allows intraoperative action to be taken and reduces the duration of surgery.

  • Rapid perfusion assessment of a planned resection zone as well as the subsequent anastomosis, including colonic anastomoses1, esophageal anastomoses, and gastric bypass anastomoses2
  • Perfusion assessment in flap plasty
  • Visualization of liver segments


1 Koh et al., Fluorescent Angiography Used to Evaluate the Perfusion Status of Anastomosis in Laparoscopic Anterior Resection, 2016

2 Boni et al., Clinical Applications of Indocyanine Green (ICG) Enhanced Fluorescence in Laparoscopic Surgery, 2015

Fluorescence cholangiography during a cholecystectomy
Fluorescence cholangiography during a cholecystectomy – Source: Prof. Luigi Boni, University of Insubria, Varese, Italy

Following intravenous administration, ICG naturally collects in the gallbladder and bile ducts. This allows the rapid and reliable identification of gallbladder and bile duct anatomy. Thanks to intuitive switching between white light and fluorescence imaging, cholecystectomy can be performed rapidly and more safely.

  • Allows the reliable differentiation between the cystic duct and common bile duct3
  • Intraoperative leaks displayed with ICG
  • Shortened surgical duration with ICG compared to standard cholangiography4


3 Boni et al., Doctor-to-Doctor Manual ENDO-PRESS®, NIR/ICG Fluorescence Imaging in Laparoscopic Surgery (ISBN 978-3-89756-934-8)

4 Dip et al., Cost analysis and effectiveness comparing the routine use of intraoperative fluorescent cholangiography with fluoroscopic cholangiogram in patients undergoing laparoscopic cholecystectomy, 2014

*SPECTRA A: Not for sale in the U.S.

Laparoscopic transverse colectomy with fluorescence-guided lymphadenectomy
Laparoscopic transverse colectomy with fluorescence-guided lymphadenectomy – Source: Prof. Luigi Boni, University of Insubria, Varese, Italy

The visualization of the lymphatic system is very helpful in many medical specialties. With NIR/ICG imaging, the entire lymphatic system5 around the tumor can be displayed in real time without use of radioactivity6.

  • Non-radioactive method for lymph node visualization
  • Detection rates compare favorably with established methods of lymph node visualization7
  • Multidisciplinary use, for instance in gynecology, urology, and general surgery


5 (S)LN by means of the intradermal administration of ICG is already approved in Italy (breast cancer), Japan and Russia. Please inform yourself in advance about the potential off-label use of ICG at your hospital and in your country.

6 Papadia et al., Doctor-to-Doctor Manual ENDO-PRESS®, ICG-Enhanced Fluorescence-Guided SLN Mapping in Gynecological Malignancies (ISBN 978-3-89756-932-4)

7 Imboden et al., A Comparison of Radiocolloid and Indocyanine Green Fluorescence Imaging, Sentinel Lymph Node Mapping in Patients with Cervical Cancer Undergoing Laparoscopic Surgery, 2015

Source: Niclas Kvarnström, M.D, Sahlgrenska University Hospital, Göteborg, Sweden
Source: Niclas Kvarnström, M.D, Sahlgrenska University Hospital, Göteborg, Sweden

A further possible application in liver surgery is the selective administration of ICG into the supply vessel in order to aid laparoscopic and open liver segmentectomy. Partial liver resection requires a sound knowledge of the existing course of the vessel and the boundaries of the individual segments as well as the diverse anatomical features of the blood vessels:

  • The tumor is localized intraoperatively aided by CT, MRI and ultrasound techniques
  • ICG is injected into the supply vessel of the segment
  • Fluorescence allows easy differentiation of the affected segment from the adjacent non-fluorescing segments

ICG fluorescence can also help to detect bile leakage following liver segmentectomy or liver transplantation procedures.

CLICKline Working Inserts for Single Use

The new cost-efficient combination possibility for laparoscopy

A selection of CLICKLINE working inserts for single use is also available now. These new CLICKLINE single-use inserts can be combined with all reusable handles and outer sheaths (length 36 cm, diameter 5 mm). Due to the modular CLICKLINE system, the user can individually assemble the desired instrument at any time.

Special Features:

  • Selection of the most commonly used KARL STORZ CLICKLINE working inserts for single use
  • Inserts sterile-packed in individual blister packs and delivered in packages of 10 in a dispenser box
  • Diverse combination possibilities
  • "Single-use meets reusable" – a cost-efficient solution for laparoscopy

CLICKline Single-use Scissors

Simply Sharp!

The new single-use scissor inserts can be combined with all reusable handles in the KARL STORZ CLICKLINE series, providing a practical solution for regular use or as a backup system.

Special Features:

  • Scissor blades are always sharp, resulting in optimal cutting effect
  • Inserts sterile-packed in individual blister packs and delivered in packages of 10 in a dispenser box
  • Proven scissor blade designs
  • Cost-effective solution: “Single-use meets reusable”
  • Color coding allows clear identification of the single-use components

Instrument Set for Minilaparoscopy

Minilaparoscopy has now become a popular surgical technique as this method – also in hybrid procedures with standard instruments (diameter 5 mm) – represents a flat learning curve for the user and enhanced cosmetic results for the patient.

Special Features:

  • Complete instrument set for minilaparoscopy (diameter 3.5 mm) available (trocars, unipolar and bipolar instruments, suction-irrigation systems, suture and ligature instruments)
  • Modular design: 3-part dismantling instruments for maximum hygiene and variability
  • Diverse combination possibilities thanks to a wide range of jaws with various outer sheaths and CLICKLINE handles
  • Additional stability due to combination with metal outer sheath
  • Rotating bipolar instruments (diameter 3.5 mm)

RoBi®

Rotating Bipolar Grasping Forceps and Scissors in sizes 3.5 mm and 5 mm

The new generation of ROBI® instruments allows precise work on tissue. The enhanced instrument design and the materials used ensure the highest mechanical stability.

Special Features:

  • Available in sizes 3.5 and 5 mm
  • Robust joint mechanism in conjunction with the force limiter ensures powerful, yet safe grasping
  • Ideal in combination with the new high-end HF unit AUTOCON® III 400 with a mode specially adapted to ROBI® instruments
  • For optimal cleaning: Can be dismantled into individual components

Flexible Video-Choledochoscopes

The flexible video choledochoscopes from KARL STORZ allow exploration of both the intra- and extrahepatic bile ducts as well as the surgical removal of gallstones.

Special Features:

  • “Chip-on-the-tip” technology for excellent image quality*
  • Compatible with the IMAGE1 S platform and backward-compatible to IMAGE 1 HUB™ HD
  • Menu navigation via camera head (e.g., Picture-in-Picture)
  • Minimal sheath circumference – 2.8 and 5.3 mm
  • Infinitely adjustable deflection up to 270°
  • Direct transmission of hand movements through to the distal end

KARL STORZ Suction and Irrigation Systems

KARL STORZ offers a wide range of suction and irrigation systems. Diverse combination possibilities for handles as well as suction and irrigation tubes can be selected to achieve the desired suction or irrigation results. The appropriate tubing systems are also available from KARL STORZ.

Special Features:

  • A broad range of suction and irrigation tubes available in various lengths and diameters allows the user to select KARL STORZ suction and irrigation systems to meet individual needs.
  • The modular system allows KARL STORZ handles to be combined with various suction and irrigation tubes as well as tubing sets.
  • Suction and irrigation systems provide powerful suction and irrigation thanks to the customary KARL STORZ high quality standards.

Discover our range of suction and irrigation systems and assemble your preferred KARL STORZ suction and irrigation system.
 

NATHANSON Liver Retractors

The new NATHANSON liver retractors are particularly characterized by a large and atraumatic surface area.

Special Features:

  • Large surface area for the stable retraction of the entire liver
  • Fatigue-free retraction when used in conjunction with a mechanical holding system
  • Available in three sizes

BERCI Fascial Closure Instrument

To prevent the risk of hernia, large trocar sites should be closed after laparoscopic interventions. KARL STORZ offers a special reusable fascial closure instrument for this purpose.

Special Features:

  • A simple, cost-effective solution for trocar site closures
  • Integrated grasping forceps facilitate the passing and retrieval of sutures during wound closure
  • Another possible application in laparoscopic hernia surgery for the fixation of the synthetic mesh to the abdominal wall

KARL STORZ KOH Macro Needle Holder, dismantling

The dismantling KOH macro needle holder (diameter 5 mm) consists of three individual parts: Handle, outer sheath and working insert. A choice of six different handles and four different working inserts allows an individual configuration of the needle holder – depending on the surgeon’s preferences.

Special Features:

  • The tungsten carbide inserts ensure stable, secure holding of the needle and suture material while still being highly resistant
  • The smooth-running, precisely settable ratchet facilitates secure positioning of the needle
  • The ergonomic design of the handles allows relaxed and precise work
  • Even better cleaning results as the instrument can be dismantled into three parts: Handle, outer sheath and working insert
  • Thanks to the modular design, only the component with the defect needs to be replaced in the event of damage – an environmentally friendly and cost-efficient solution

IMAGE1 S

Hybrid Platform for Flexible Endoscopy in Surgery

Flexible endoscopy is becoming increasingly prevalent in general and visceral surgery. The modular IMAGE1 S camera system combines rigid (2D and 3D) as well as flexible endoscopy in one system and thus allows the use of both applications.

Special Features:

  • For use with KARL STORZ video endoscopes (video choledochoscopes, TROIDL flexible rectoscopes, colonoscopes, gastroscopes)
  • Possible to combine rigid and flexible endoscopy thanks to the modular IMAGE1 S camera platform
  • Picture-in-Picture mode enables the simultaneous display of laparoscopic and endoscopic images
  • Cost-effective solution as it eliminates the need for a second video tower

KARL STORZ TROIDL SILVER SCOPE® Flexible Rectoscope

The flexible TROIDL SILVER SCOPE® rectoscope combines the fundamental advantages of flexible endoscopy with the application possibilities of rectoscopy.

Special Features:

  • Working length of 40 cm ensures easy handling
  • Up to 210° inversion improves visualization and, consequently, diagnostic and therapeutic options thanks to forward and retrograde viewing
  • Field of application especially suited for surgical conditions and procedures in the rectal area
  • Fatigue-free work thanks to ergonomically shaped control unit
  • Possibility to combine rigid and flexible endoscopy thanks to modular IMAGE1 S camera platform