Popis: |
Background Laparoscopic surgery is widely accepted as minimally invasive surgery; however, obstacles to its functional optimization remain. One such challenge is that each surgical port can accommodate only one instrument at a time. Complex manipulations are therefore necessary to exchange one laparoscopic tool with another during surgery (e.g., removal of forceps and placement of a suction tube), which increases operation times and risk to patients. We developed a new laparoscopic instrument that functions as both forceps and a suction tube, which renders intraoperative tool exchange unnecessary. This prospective pilot study was undertaken to evaluate the safety and efficacy of this novel dual-function device in laparoscopic surgery for gastric cancer. Methods This single-center prospective pilot study was undertaken with 15 patients who required laparoscopic distal gastrectomy for gastric cancer. To assess patient safety, intraoperative video was used to document any tissue damage associated with the new instrument. To evaluate instrument efficacy, we measured the time interval between the start of bleeding and the start of aspiration (“suction access time”) and compared this time with that of a conventional surgical setup. Results All procedures were successful, and no excess tissue damage occurred during surgery with the suction-tip forceps. Bleeding occurred 158 times. Suction access time was significantly shorter in cases of bleeding when the suction-tip forceps were used (2.01 seconds) than when an ordinary suction tube was used for aspiration (12.5 seconds; P < 0.01). Conclusion These findings suggest that our new suction-tip forceps are a useful, safe, and efficacious operative tool. This surgical innovation may considerably simplify gastric laparoscopic surgery. This pilot study was registered with Japan Clinical Trial Registration on June 22, 2017 (registration number: UMIN000027879). |