PubMed · 7265849
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V P Strekalovskiĭ, G D Kolesnikova, V M Arablinskiĭ. 1981. [Enteroscopy].. https://pubmed.ncbi.nlm.nih.gov/7265849/
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A novel retractor has been designed to achieve atraumatic retraction of the liver and displacement of hollow viscera during endoscopic surgery. The functional section of the instrument, when locked, forms a silicon-covered uniplanar hook which can be deployed for horizontal lift of solid organs such as the liver or be used to engage bowel for displacement from the operative field. Following laboratory testing, the instrument has been evaluated clinically and its ease of deployment and atraumatic nature have been confirmed. It has been found to be particularly effective for elevation of the thick fatty left lobe of the liver during antireflux surgery.
Recently a number of manufacturers have developed three-dimensional (3-D) video systems which significantly improve visualization and enhance the ability of the surgeon to perform delicate endoscopic dissection and suturing. These 3-D video systems may also improve the education of surgeons-in-training as they would have a better understanding of three-dimensional anatomy during laparoscopic surgery. Most of the 3-dimensional stereoendoscopic video systems currently available have four basic principles of stereoendoscopic image processing in common: image capture, conversion of 60-120 Hz images; presentation of left and right images on a single monitor; and separation of the left and right eye images. Skill tests performed assessing laparoscopic suturing and knot tying have demonstrated a 25% increase in speed and accuracy of these laparoscopic tasks when utilizing a three-dimensional video imaging greatly facilitates the efficiency of endoscopic reconstructive procedures. While three-dimensional video imaging systems are more costly than conventional two-dimensional video equipment, the enhanced depth perception produced by 3-D endoscopes has been demonstrated to improve the performance of minimally invasive surgical procedures.
There has been an explosive interest in endoscopic techniques by plastic surgeons over the past two years. Procedures such as facial rejuvenation, breast augmentation and abdominoplasty are being performed with endoscopic assistance. Endoscopic operations require a complex setup with components such as video camera, light sources, cables and hard instruments. The Hopkins Rod Lens system consists of optical fibers for illumination, an objective lens, an image retrieval system, a series of rods and lenses, and an eyepiece for image collection. Good illumination of the body cavity is essential for endoscopic procedures. Placement of the video camera on the eyepiece of the endoscope gives a clear, brightly illuminated large image on the monitor. The video monitor provides the surgical team with the endoscopic image. It is important to become familiar with the equipment before actually doing cases. Several options exist for staff education. In the operating room the endoscopic cart needs to be positioned to allow a clear unrestricted view of the video monitor by the surgeon and the operating team. Fogging of the endoscope may be prevented during induction by using FREDD (a fog reduction/elimination device) or a warm bath. The camera needs to be white balanced. During the procedure, the nurse monitors the level of dissection and assesses for clogging of the suction.