For many patients of select demographics, single incision and robotic laparoscopic surgery are excellent solutions to addressing their surgical concerns. Many surgeons are eager to apply these approaches, however they find new challenges during the application of some “bread and butter” surgical products. Industry has responded with some smart solutions—we can look to the introduction of articulating endoscopes and articulating L-hooks as examples.
One of the most basic surgical techniques the industry has addressed for single incision and robotic surgery is organ retraction. We know that organ retraction is an aspect of a laparoscopic procedure which is critical for obtaining good access to the surgical site. In many ways, organ retraction can make or break a surgery case based on how well the device performs for that given procedure. During single incision surgery, an additional incision to the abdomen may be required to retract the targeted organ (i.e. liver, gall bladder, etc.). Doing this cancels out the idea of single incision surgery. Surgeons should look to utilize intracorporeal retraction solutions where possible—this allows them to apply the retractor while maintaining a single site approach.
For robotic surgery, retraction is typically achieved via an assistant or holding arm maintaining the position of a grasper or traditional retractor. A solution which is intracorporeal should also be considered here. This eliminates the chance of the retractor being bumped by the robotic arms, and frees up the assistant to focus on other aspects of the case.
Another special consideration for laparoscopic organ retraction is patient recovery. Limiting the number of skin incisions by utilizing an intracorporeal solution will eliminate a source of post-operative pain or discomfort and may reduce the time to recovery.