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Highlights in Laparoscopic Surgery

Laparoscopy in Surgery, Gynecology, and Urology

Retractors for Laparoscopic Colorectal Procedures

Advanced laparoscopic surgery and particularly laparoscopic rectal surgery are extremely technically challenging.

One of the key requirements for successfully performing these procedures while respecting oncological principles is optimal exposure and, consequently, good visualization of the surgical site.

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, now also available as a sterile version
  • 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

S-PILOT® – modular smoke evacuation system

As an early pioneer in laparoscopy, KARL STORZ has consistently worked to advance the state of the art. A great example is the S-PILOT® modular smoke evacuation management system, with in-line filtration and options for both active and passive applications. Recent guidance from SAGES and EAES recommends “For MIS procedures, use of devices to filter released CO2 for aerosolized particles should be strongly considered”.
While KARL STORZ has not specifically tested the use of KARL STORZ smoke evacuation devices and SARS-CoV-2, there are data on KARL STORZ filters and its effectiveness against other bacteria and viruses.    
The filter efficiency of KARL STORZ filters was tested using the most common test methods with microorganisms known as “Virus Filtration Efficiency (VFE)” and “Bacterial Filtration Efficiency (BFE)”. These types of tests are considered to be the most similar to clinical scenarios. A test aerosol with a mean particle size of 3 +/- 0.3 µm and a virus bacteriophage ɸX174 of 0.027 µm (at VFE) or bacteria Staphylococcus aureus (at BFE) were used. Test results confirmed a filter efficiency of more than 99.9999 %.1,2
The Most Penetrating Particle Size is typically in a range of 0.1-0.3 µm. These particles are the most difficult to trap by the filter. The test aerosol DEHS (= Di-2-Ethylhexyl-Sebacat) with a size of 0.3 µm was therefore used for non-microbiological tests. A filter efficiency of more than 99.9994 % was achieved.3

Contact your local KARL STORZ representative for a solution that meets your individual needs or for more details regarding the smoke evacuation portfolio available.
The S-PILOT® with in-line filtration is part of the extensive array of KARL STORZ products designed in consultation with active laparoscopic surgeons. The complete repertoire covers the full range of diagnostic and surgical laparoscopic procedures for adult and pediatric patients. 
 

1 Nelson Laboratories Inc., Salt Lake City, USA: “Virus Filtration Efficiency Test (VFE) at an Increased Challenge Level” Lab. No. 846021-S01, 07 Dec. 2015 (internal reference: SAP ID 300000338072).

2 Nelson Laboratories Inc., Salt Lake City, USA: “Bacterial Filtration Efficiency Test (BFE) at an Increased Challenge Level” Lab. No. 846022-S01, 02 Dec. 2015 (internal reference: SAP ID 300000338073).

3 GVS Filter Technology UK, Lancashire LA3 3EN, UK: Activity Report REP: 0698/16, 21. January 2016 (internal reference: SAP ID 300000351254).

EndoCAMeleon® Telescope with Variable Direction of View

The ENDOCAMELEON® HOPKINS® telescope with rod lens system and a rigid 10 mm sheath offers a variable direction of view. This allows optimal adjustment of the viewing direction to any OR situation.

Special Features:

  • Variable direction of view 0° – 90°
  • Enhanced illumination
  • Easy-to-use adjustment knob for selecting the direction of view, now with fin
  • Combines the convenient handling of the proven HOPKINS® telescope with the advantages and potential of a telescope offering various directions of view
  • Particularly suitable for use in anatomically narrow working spaces

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
  • Now with new imaging option: Choice between green and blue fluorescence coloring

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

The selective administration of ICG assists the identification of various liver segments during partial liver resection in both laparoscopic and open surgical procedures. Partial liver resection requires a sound knowledge of the existing course of the vessel and the boundaries of the individual segments while taking the diverse anatomical features of the blood vessels into consideration:

  • The tumor is localized pre- or 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.

S-PORT®

S-PORT® is a single-port platform that is suitable for performing hybrid procedures (LAP / Single Port) where the single-port entry can also be used as an extraction site.

Special Features:

  • Modular system
  • Great freedom of movement
  • Stable platform for precise control of telescopes and instruments
  • Simple extraction of resected tissue
  • Variable adjustment of the incision size
  • Cost-effective and reusable, except for the wound protector
  • Can be combined with ROTATIP® instruments featuring jaw and sheath rotation

TELESCOPES

HOPKINS telescopes adapted to the demands of single-port surgery

Special Features:

  • Light connection offset by 180° and angled 45°
  • Extra-long (50 cm) telescope
  • Diameter 5.5 mm
  • Also available in 0° and 45°

Scope Warmer

For fog-free work and brilliant imaging

  • No fogging of the endoscope, providing greater patient safety and reducing surgery time
  • Convenient handling as no other heat source (electricity, warm water, etc.) is required
  • Product is sterile on delivery and is ready for immediate use
  • Two scopes can be heated in the warmer at the same time
  • Available in two different sizes
  • Can be used for approx. 2 hours after activation

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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

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

Needle Holder with Righting Function

KARL STORZ has expanded its portfolio to include a new needle holder with a needle righting function. The needle holder offers significant time and handling advantages, especially for interrupted suturing. The needle, which is clamped flat in the needle holder, can be raised at the site by means of the rotary wheel.

Special Features:

  • Righting function for the clamped needle by turning the rotary wheel
  • The ergonomic handle design allows relaxed and precise work
  • The smooth-running, precisely settable ratchet facilitates secure positioning of the needle

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

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)

ENDOBAG Extraction Bags

Special features:

  • Each extraction bag pre-packaged in an insertion aid: easy insertion through 10 mm trocar
  • Simple insertion of the extraction bag through the pusher. The trocar can then be used for other instruments
  • Self-opening ENDOBAG: no time-consuming opening of the extraction bag
  • Unique, patented shape: simplified retrieval of the ENDOBAG, in some cases preventing enlargement of the incision
  • Tear-resistant and transparent material: high levels of safety and protection from contamination

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