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Annals of Biomedical Engineering

, Volume 42, Issue 9, pp 1942–1951 | Cite as

Design, Development and Evaluation of an Inflatable Retractor for Atraumatic Retraction in Laparoscopic Colectomy

  • Conor O’Shea
  • Denis Kelliher
  • Emmet Andrews
  • Mícheál O’Ríordáin
  • Michael O’Shea
  • Timothy Power
  • Pádraig Cantillon-Murphy
Article

Abstract

Laparoscopic colectomy is the gold standard in the treatment of malignant tumours arising in the mucosa of the colon wall. The procedure is performed under general endotracheal anaesthesia and involves establishing a pneumoperitoneum with the patient in the Trendelenburg position. However this position can cause anaesthetic difficulties due to excess blood flow to the head and neck, increased pressure on the diaphragm and increased venous pressure. In the absence of steep head-down positioning, the bowels fall or “spill” into the operating field, obstructing the surgical space. The primary goal of this work is to design an atraumatic laparoscopic retractor to minimise the Trendelenburg position whilst effectively retracting the bowels from the operating field. This work details the design, evaluation and optimisation of a novel, hand held, inflatable, laparoscopic retractor, through physical experimentation, computer simulation, and pre-clinical animal investigation. The optimised design for the inflatable retractor performs in line with simulated expectations, and was successfully tested for safety and technical feasibility in vivo in a porcine model, where the bowels were effectively removed from the operating space whilst the model remained in the supine position. These initial results represent a promising approach for the mitigation of the Trendelenburg position, whilst effectively retracting the bowels during laparoscopic colectomy, using this atraumatic, inflatable retractor.

Keywords

Laparoscopic colectomy Laparoscopic instruments Inflatable retractor Bowel retraction Atraumatic retractor 

Notes

Acknowledgments

The authors thank the Biological Services Unit and UCC Department of Physiology for facilitating the pre-clinical animal investigation, in particular Mr. Kieran McManamon, and Dr. Therese Ruane-O’Hora.

Disclosures

The authors of this paper have no conflict of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MP4 21188 kb)

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Copyright information

© Biomedical Engineering Society 2014

Authors and Affiliations

  • Conor O’Shea
    • 1
  • Denis Kelliher
    • 1
  • Emmet Andrews
    • 2
    • 3
  • Mícheál O’Ríordáin
    • 4
  • Michael O’Shea
    • 1
  • Timothy Power
    • 1
  • Pádraig Cantillon-Murphy
    • 1
  1. 1.School of Engineering, Electrical and Electronic EngineeringUniversity College CorkCorkIreland
  2. 2.Department of Colorectal SurgeryCork University HospitalCorkIreland
  3. 3.School of MedicineUniversity College CorkCorkIreland
  4. 4.Department of Colorectal SurgeryMercy University HospitalCorkIreland

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