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Brigmon EP, Eastridge B. TITAN CSR: a new self-retaining retractor for abdominal surgery. Trauma Surg Acute Care Open 2023; 8:e001164. [PMID: 38020858 PMCID: PMC10649783 DOI: 10.1136/tsaco-2023-001164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Background Self-retaining retractors provide hands-free exposure and allow surgeons to use their hands to perform surgery rather than manually retract tissues. Non-table-mounted retractors offer rapid assembly, but they have been traditionally limited in their ability to provide adequate exposure of the abdomen. Table-mounted retractors provide excellent exposure, but their cumbersome and time-intensive assembly often precludes their use in emergency settings. The TITAN CSR surgical retractor is a novel, lightweight, expandable, and modular system which offers the benefits of both designs by providing rapid assembly and effective abdominal exposure without a table attachment. We describe our experience with this new retractor system. Methods Retrospective case series of selected trauma and emergency surgery laparotomies at an urban academic level 1 trauma center using the TITAN CSR surgical retractor during a 1-year period. Results The TITAN CSR surgical retractor was used to provide exposure for trauma and emergency surgery laparotomies in both adult and pediatric patients in 89 cases from July 2021 to July 2022. Without requiring a table attachment, the TITAN CSR retractor provided hands-free surgical exposure during a variety of procedures including traumatic hysterectomy, gastrorrhaphy, enterorrhaphies and colectomy. With the added utility of attaching Bookwalter-compatible retractor blades, it provided effective exposure of retroperitoneal structures. These structures included the inferior vena cava, left femoral vessels, and duodenum. All laparotomies presented were successfully completed without setting up a post or a connection to the surgical table. Discussion The TITAN CSR surgical retractor was successfully used in a number of difficult trauma and emergency surgery laparotomies, providing effective intra-abdominal and retroperitoneal exposure without necessitating an attachment to the surgical table. This retractor has the potential to replace current retractor systems in abdominal surgery, providing the benefits of table-mounted and non-table-mounted designs while removing their various disadvantages.
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Affiliation(s)
- Erika Paola Brigmon
- Trauma and Emergency General Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Brian Eastridge
- Trauma and Emergency General Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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Zhu L, Shen J, Yang S, Song A. Robot-Assisted Retraction for Transoral Surgery. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3211491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Lifeng Zhu
- State Key Laboratory of Bioelectronics, Jiangsu Key Lab of Remote Measurement and Control, School of Instrument Science and Engineering, Southeast University, Nanjing, China
| | - Jiangwei Shen
- State Key Laboratory of Bioelectronics, Jiangsu Key Lab of Remote Measurement and Control, School of Instrument Science and Engineering, Southeast University, Nanjing, China
| | - Shuyan Yang
- State Key Laboratory of Bioelectronics, Jiangsu Key Lab of Remote Measurement and Control, School of Instrument Science and Engineering, Southeast University, Nanjing, China
| | - Aiguo Song
- State Key Laboratory of Bioelectronics, Jiangsu Key Lab of Remote Measurement and Control, School of Instrument Science and Engineering, Southeast University, Nanjing, China
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Jayasuriya NSS, Ratnapreya S, Senarathna L, Kapugama K. Self-Retaining Photography Cheek Retractor as an Excellent Aid for Upper Jaw Surgeries: A Technical Note. J Maxillofac Oral Surg 2022; 21:785-786. [PMID: 36274871 PMCID: PMC9474987 DOI: 10.1007/s12663-021-01602-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022] Open
Abstract
Background Proper retraction of soft and hard tissues is essential to a successful surgery. The Technique The authors wish to report the use of a self-retaining photography cheek retractor during a Le Fort 1 surgery and an alveolar bone graft surgery which proved beneficial by achieving very good retraction. Conclusion This is an eye opener to modify the traditional photography retractor to maximise its benefits as a retractor in Oral and Maxillofacial surgery.
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Affiliation(s)
| | - Sakuntha Ratnapreya
- Department of Dental Surgery, Asiri Surgical Hospital,
Colombo 05
, Sri Lanka
| | - Loshan Senarathna
- Department of Oral and Maxillofacial Surgery, Dental Teaching Hospital, Peradeniya, Sri Lanka
| | - Kanchana Kapugama
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Attanasio A, Scaglioni B, Leonetti M, Frangi AF, Cross W, Biyani CS, Valdastri P. Autonomous Tissue Retraction in Robotic Assisted Minimally Invasive Surgery – A Feasibility Study. IEEE Robot Autom Lett 2020. [DOI: 10.1109/lra.2020.3013914] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Martell K, Law C, Hasan Y, Taggar A, Barnes E, Ravi A, Leung E. Using infrared depth-sensing technology to improve the brachytherapy operating room experience. Brachytherapy 2020; 19:323-327. [PMID: 32220519 DOI: 10.1016/j.brachy.2020.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to discuss the merits of using depth-sensing infrared camera technology in the brachytherapy operating room during interstitial brachytherapy for gynecologic malignancies. MATERIALS AND METHODS The infrared depth-sensing camera from a Microsoft Kinect that had been adapted for surgical use was introduced into a high-volume interstitial brachytherapy operating room. Brachytherapists then used the touchless, gestural interface to review preoperative MRI in real time to guide needle insertion. RESULTS The interface was used for 10 consecutive procedures by 4 separate brachytherapists. The initial training and adjustment to the technology was variable among brachytherapists. All brachytherapists found the controls intuitive and were able to successfully navigate MRI on the system after 1, 30, 30, and 45 min. Qualitatively, brachytherapists found the system helpful for interpretation of intraoperative ultrasound imaging. Furthermore, it ensured adequate needle positioning and deposition was maintained for large tumors. Surgeons involved in its use agreed on potential for considerable benefit when performing interstitial brachytherapy. CONCLUSIONS Adapting this technology for use in the brachytherapy suite provided a higher level of comfort with interstitial catheter placement. This novel tool or similar technology might be considered within other brachytherapy suites.
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Affiliation(s)
- Kevin Martell
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario; Department of Oncology, University of Calgary, Calgary, Alberta; Tom Baker Cancer Centre, Calgary, Alberta
| | - Calvin Law
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Yaser Hasan
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Amandeep Taggar
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Elizabeth Barnes
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Ananth Ravi
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Eric Leung
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario.
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Cavallo A, Brancadoro M, Tognarelli S, Menciassi A. A Soft Retraction System for Surgery Based on Ferromagnetic Materials and Granular Jamming. Soft Robot 2018; 6:161-173. [PMID: 30407125 DOI: 10.1089/soro.2018.0014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In recent years, minimally invasive surgery (MIS) has gained wider acceptance among surgeons. MIS requires high skills for the operators, mainly due to its intrinsic technical limitations. Tissue manipulation and retraction remain the most challenging tasks; more specifically liver, stomach, and intestine are the organs mostly involved in retraction tasks for abdominal procedures. The literature reports an increasing interest toward dedicated solutions for abdominal tissue retraction tasks. To overcome the limitations of commercial systems and research prototypes, the aim of this study is the design, the realization, and the validation of a retraction system that is simple, reliable, easy to use, safe, and broadly compatible with MIS. The proposed retractor has two main components: (1) a soft central part with variable stiffness obtained by exploiting the granular jamming phenomenon for assuring, at the same time, safe introduction into the abdominal cavity and stable retraction and (2) two iron cylinders located at the two extremities of the device for anchoring the retractor to the abdominal wall by using the magnetic attraction force between these components and two external permanent magnets. System design has been performed by deeply investigating granular jamming principle and ferromagnetic properties of iron elements. Ex vivo and in vivo assessment has been carried out with the final aim to identify the most appropriate design of each retractor component and to demonstrate the advantages of using a soft system with variable stiffness during a retraction task.
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Affiliation(s)
- Aida Cavallo
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
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Brancadoro M, Tognarelli S, Ciuti G, Menciassi A. A novel magnetic-driven tissue retraction device for minimally invasive surgery. MINIM INVASIV THER 2016; 26:7-14. [PMID: 27616428 DOI: 10.1080/13645706.2016.1234488] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION The purpose of this work is to design and validate an innovative magnetic-based device for tissue retraction for minimally invasive surgery. MATERIAL AND METHODS An intra-abdominal magnetic module is coupled with an extracorporeal system for establishing a stable attraction, and consequently a reliable tissue retraction. Once the retractor has been inserted into the abdomen, tissue retraction is not constrained by a fixed access port, thus guaranteeing a more flexible, safer and less invasive operation. The intra-abdominal unit is composed of an axial permanent magnet attached to a stainless-steel non-magnetic alligator clip by a traditional suturing thread. A miniaturized mechanism to adjust the length of the suturing thread for lengthening or shortening the distance between the tissue grasper and the internal magnetic unit is included. A multiphysics approach assured a dedicated design that thoroughly fulfills anatomical, physiological and engineering constraints. RESULTS System functionalities were demonstrated both in in-vitro and ex-vivo conditions, reaching good results and promising outcomes in terms of effectiveness and maneuverability. The retractor was successfully tested in an animal model, carrying out a whole retraction procedure. CONCLUSION The proposed retraction system resulted to be intuitive, reliable, robust and easy to use, representing a suitable device for MIS procedures.
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Affiliation(s)
| | - Selene Tognarelli
- a Scuola Superiore Sant'Anna , The BioRobotics Institute , Pontedera , Pisa , Italy
| | - Gastone Ciuti
- a Scuola Superiore Sant'Anna , The BioRobotics Institute , Pontedera , Pisa , Italy
| | - Arianna Menciassi
- a Scuola Superiore Sant'Anna , The BioRobotics Institute , Pontedera , Pisa , Italy
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