Initial experiences of a novel self-retaining intracorporeal retractor device for urologic laparoendoscopic single-site surgery

Abstract

BACKGROUND AND PURPOSE: Laparoendoscopic single-site surgery (LESS) is a surgical

option for a number of urologic operations, although it does carry technical

limitations. One of the major obstacles in performing LESS is accomplishing

optimal retraction of adjacent organs. The aim of this study was to investigate

the feasibility of a novel self-retaining intracorporeal retractor device, the

Internal Organ Retractor (IOR), and to describe our experience using this device

in LESS. PATIENTS AND METHODS: A total of 23 patients who underwent LESS using

IOR between December 2012 and July 2013 were identified. Among these patients, 11

nephrectomies, 9 adrenalectomies, 1 pyeloplasty, and 2 nephroureterectomies were

performed. Perioperative outcomes including operative time, complications related

to use of the IOR, and amount of time needed for the application and removal of

the IOR were measured during each operation. RESULTS: Adequate retraction was

accomplished in all surgical cases. The IOR helped to maintain a consistent

operative field throughout the surgery. A median application time of a single IOR

was 85.0 (range 44.5-187.5) seconds and removal time was 50.0 (20-400) seconds.

The median number of IOR sets used was 2.0 (range 1-4), and the median total

application and removal time in a single operation were 170.0 (45-750) seconds

and 95.0 (20-400) seconds, respectively. There were no perioperative

complications associated with use of the IOR. CONCLUSIONS: The IOR provided

satisfactory retraction during LESS, and its application/removal was

uncomplicated and needed a minimal amount of time. The IOR reduced the need for

additional laparoscopic ports for retraction. We believe that the IOR is a useful

retraction tool for LESS and possibly multiport laparoscopic surgeries.