By Jeffrey W. Milsom MD, Bartholomäus Böhm MD, PhD (auth.)
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Extra resources for Laparoscopic Colorectal Surgery
1993;128: 105-108. 8. Duh QY, Way LW. Laparoseopie gastrostomy using T-fasteners as retractors and anchors. Surg Endosc. 1993;7:60-63. 9. Banting S, Shimi S, Velpen Vander G, Cuschieri A. Abdominal lift. Low-pressure pneumoperitoneum laparoscopic surgery. Surg Endosc. 1993;7:57 -59. 10. Hashimoto D, Nayeem SA, Kajiwara S, Hoshino T. Laparoscopic cholecystectomy: an approach without pneumoperitoneum. Surg Endosc. 1993;7:54-56. 11. Cava A, Roman J, Gonzalez Quintela A, Martin F, Aramburo P. Subcutaneous metastasis following laparoscopy in gastric adenocarcinoma.
These designs may be useful to retract the liver or other more fixed organs, but it is not designed to retract the bowel effectively. Fan retractors also have the disadvantages that an intestinal loop may become trapped between the fingers of the retractor, exposing the loop to potential injury. Currently, the size of most retractors (fan or paddle) is limited because of the small diameters of the cannulas. No optimal device for retracting intestinalloops exists. A new 3. Basic Laparoscopic Instruments device that might be used with a 12-mm cannula and work as an intraperitoneal barrier far the small bowel is currently under investigation in our laboratory.
At temperatures over 500°C, tissue bums and evaporates. l. Advantages and disadvantages of scissors with electrosurgery, Contact Laser*, ultrasonic scalpel, and ultrasonic dissector in laparoscopic colorectal surgery. Scissors with electrosurgery Advantages Disadvantages Good cutting and coagulation Inexpensive Familiar technique for nearly all surgeons High smoke development Higher risk of inadvertentl unrecognized injury Ultrasonic dissector Contact Laser Ultrasonic scalpel Precision in cutting Moderate hemostasis Less smoke development Good cutting Moderate hemostasis No smoke development Low risk of inadvertent injury Difficult coagulation Unfamiliar technique Expensive equipment Difficult coagulation Mist development Unfamiliar technique No cutting No coagulation Unfamiliar technique *Surgical Laser Technologies Corporation, Oaks, Pa.