News from Manufacturing Companies
Introduction S-PORTAL®
A new operating technique is gaining ground, which might be considered as a further evolution of Minimally Invasive, or Minimal Access Surgery, closely related to the NOTES idea with the same principle: to further reduce the access trauma, to minimize complications and achieve a far better cosmetic result.
The fundamental idea is to bring all necessary instruments through one strictly confined local area, or in other words: one single portal. Because the incision is usually made in the navel the scar is invisible.
KARL STORZ GmbH has created the new trade mark S-PORTAL® to encompass the somehow different but substantially similar approaches through a single portal of entry for the camera and instrumentation.
One major difficulty in S-PORTAL® procedures is the reduction of free manoeuvring space and the potential collision of instruments and telescope. Distally and/or proximally curved instruments, the combined use of different shaft lengths and the right selection of handles suggest a solution. Also an extended length telescope will move the hands of the camera assistant in distance to the area needed by the operator.
S-PORTAL® instruments in combined use with an extended length telescope and the IMAGE1™ 3-chip HD camera for optimal performance is recommended.
Single Port with X-CONE and/or ENDOCONE®
For the single port access KARL STORZ has designed two transumbilical access devices: ENDOCONE® (in cooperation with Prof. Sir Alfred Cuschieri) and X-CONE (with the University of Würzburg, Germany as clinical advisor).
ENDOCONE®
The ENDOCONE® was developed as a holistic solution (port-instruments-retraction system). The use of proximally deviating curved instruments increases the operative space between the surgeon’s hands and facilitates the performance of various surgical procedures, e.g., adnexectomy, cystectomy, etc.
The proximal conical section of the ENDOCONE® is capped with a separate seal cap (bulkhead) which houses 8 valved instrument seals: two along large midline (for instruments up to 15 mm diameter) and 6 (three on either side) for instruments up to 5 mm in diameter. The reason is to offer alternatives in the positioning of the instruments in relation to each for the best ergonomic result. The fixed positions of the holes thereby act like a fulcrum stabilizing the movements of the instruments.
X-CONE
The device consists of two symmetric metal X shaped half shells and one silicone cap with the ports. In a 2 cm long umbilical incision the atraumatic halves are successively inserted in a similar manner as retractors and joined to form a sealing cone using a simple pivoting movement.
The advantages of both devices:
reusable therefore cost effective
easy handling and application
access under direct view
stable platform for the precision handling of optics and instruments
varied instrument accesses for optimized instrument positioning
use of straight and curved instruments between 3 mm and
12,5 mm
Hand instruments
Triangulation of instruments is one of the bases of laparoscopy. Preferably, the laparoscope is located in the vertical plane at the bisector of the angle. In the context of S-PORTAL® procedures, this is primarily achieved by the use of curved instruments. The use of a special extra-long telescope or the ENDOCAMELEON® reduces the risk of instrument collisions and creates the perfect conditions for optimal image quality and ergonomic working conditions, as it is compatible with high-resolution, true-color 3-chip HD cameras
(IMAGE 1 HD).
Comprehensive selection of retraction, preparation and dissection instruments with different curvatures, jaw parts and handles in the reliable CLICKLINE system
Imaging ENDOCAMELEON®
Until now, surgeons had to choose in advance which telescopes to use in a procedure. They were generally able to select from telescopes with 0°, 30° or 45° viewing directions, but were restricted to the selected direction throughout surgery or had to perform an intraoperative telescope change to obtain another viewing direction required for the specific procedure. KARL STORZ now offers a better solution:
ENDOCAMELEON® – the new laparoscope with variable direction of view.
The new ENDOCAMELEON® combines the familiar tried and tested procedural comfort of a conventional 0° HOPKINS® rod lens telescope with the advantages and potential of a laparoscope featuring variable viewing direction.
Our new and innovative laparoscope allows the user to quickly and easily adjust the viewing direction between 0° and 120° as the conditions require. As a result, intraoperative telescope changes have become unnecessary, and the surgeon is able to optimally view the entire surgical field. The new ENDOCAMELEON® permits optimal visualization, even of regions that cannot be viewed with traditional laparoscopes.
Moreover, the new ENDOCAMELEON® also scores in relation to cost effectiveness – a laparoscope that truly meets all requirements.
The ENDOCAMELEON® is available in the standard working length
33 cm and also in an extra long version (42 cm).
Applications of this innovative and universal laparoscope are all laparoscopic/endoscopic procedures in surgery, urology and gynaecology.
An excellent image quality can be achieved with the new ENDOCAMELEON® in combination with our innovative KARL STORZ IMAGE 1 HD system.
