Biomedical subjects

A M Ternamian

Publications and source records attributed to A M Ternamian.

3 recordsLinked to original sources

PubMed1999

Endoscopic threaded imaging port (EndoTIP) for laparoscopy: experience with different body weights.

BACKGROUND: A laparoscopic access system was developed for primary port insertion. The cannula requires no trocar and no axial penetration force during insertion. It provides magnified visualization through the scope on the monitor during access and exit. The device has a proximal valve section and a distal cannula section with a single thread winding around its outer surface, ending in a blunt tip. After umbilical incision and Veress insufflation, a 0 degrees laparoscope is mounted in the cannula. The tip of the cannula is inserted into a tiny fascial incision and rotated clockwise. The fascia and then the muscle fibers spread radially and are transposed onto the cannula's outer thread. The thin peritoneum transilluminates; bowel, vessels, and/or adhesions are visualized before entry into the peritoneum. METHODS: The cannula was used in 234 consecutive patients: 8.1% were markedly obese, with a body mass index (BMI) > or =35, 14.8% were moderately obese (BMI 30 to <35), and 77.1% were mildly obese or normal (BMI <30). RESULTS: There were no instrument-related or insertion-related complications. No insertion failed. Insertion time was slightly longer in the morbidly obese patients who had had previous umbilical surgical incisions. No port-site hernias have been found thus far (follow-up 6-48 months). CONCLUSION: This reusable cannula was found to be safe for any body weight.

Body Mass Index↗

PubMed1998

A trocarless, reusable, visual-access cannula for safer laparoscopy; an update.

A new instrument for laparoscopic access consists of a trocarless, reusable, visual-access cannula with an external thread that ends in a blunt tip. The device has no sharp ends or moving parts. The cannula does not transect but radially stretches and elevates vessels, fascia, and muscle fibers, preserving the fascia's natural gridiron shutter mechanism at the access site. The outer thread stabilizes the cannula, and no fascial suture is necessary. In a prospective clinical trial between 1994 and 1997, the instrument was used in 203 patients requiring 234 access ports for diagnostic and operative laparoscopies. No device-related complications or failed attempts were recorded. The cannula caused less tissue trauma at access sites, and may decrease the frequency of hernias and postoperative access site pain.

Adolescent↗

PubMed1997

Laparoscopy without trocars.

BACKGROUND: Laparoscopic access devices have consisted of a cannula and sharp trocar. A trocarless endoscopic access cannula was designed to improve safety, eliminate blind entry, save time, and decrease cost. It consists of a threaded hollow cannula with a blunt penetrating distal end. METHODS: After pneumoperitoneum is established with the Veress needle, the laparoscope is inserted into the cannula, and using the blunt tip at the distal end of the thread, the anterior rectus fascia is engaged through a 5-7 mm horizontal fascial incision. Rotation advances the blunt cannula tip past the anterior rectus fascia, muscle, and posterior rectus fascia and through the peritoneum under continuous video control with no axial force. RESULTS: The trocarless rotational access cannula (TRAC) was used successfully in 135 consecutive unselected patients with no complications. CONCLUSIONS: This access cannula and methods offer many advantages while improving safety and cost.

Adolescent↗