Grasping and dissecting instrument for hand-assisted laparoscopic surgery: development and early clinical experience.
BACKGROUND
The operative potential of hand-assisted laparoscopic surgery (HALS) could be enhanced by the introduction of a new generation of assisting instruments. These tools will have to meet specific requirements of shape, function, and safety of use.


METHODS
Problems related to the working environment of HALS and deriving projectual restrictions of HALS instruments were analyzed in order to develop and manufacture a working prototype with grasping and dissecting properties to assist during HALS procedures. The resulting instrument was mechanically and clinically tested in 22 HALS procedures.


RESULTS
The additional benefit of the new device was particularly appreciated during dissection and isolation of vascular pedicles (nephrectomies and splenectomies). It was shown to be safe and effective in providing the additional assistance it was designed for.


CONCLUSIONS
The described grasping and dissecting instrument for HALS is of great value in assisting the surgeon during fine dissection, as required in selected procedures. New generation of HALS instruments should comply with the functional and safety issues analyzed in this report.
Pietrabissa
A
A
Divisione di Chirurgia Generale e Trapianti, Dipartimento di Oncologia, dei Trapianti e delle Nuove Tecnologie in Medicina, Università di Pisa, Pisa, Italy. apietrabissa@med.unipi.it
Dario
P
P
Ferrari
M
M
Stefanini
C
C
Menciassi
A
A
Moretto
C
C
Mosca
F
F
D004867:Equipment Design / Q000639:trends; D006801:Humans; D020706:Laparoscopes / Q000639:trends*; D010535:Laparoscopy / Q000379:methods* / Q000639:trends*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000639:trends; D009392:Nephrectomy / Q000295:instrumentation / Q000639:trends; D013156:Splenectomy / Q000295:instrumentation / Q000639:trends