Top

Published in:

01-02-2014 | 2013 SSAT Poster Presentation

Design, Development, and Evaluation of a Novel Retraction Device for Gallbladder Extraction During Laparoscopic Cholecystectomy

Authors: Joshua M. Judge, George J. Stukenborg, William F. Johnston, William H. Guilford, Craig L. Slingluff Jr., Peter T. Hallowell

Published in: Journal of Gastrointestinal Surgery | Issue 2/2014

Abstract

Background

A source of frustration during laparoscopic cholecystectomy involves extraction of the gallbladder through port sites smaller than the gallbladder itself. We describe the development and testing of a novel device for the safe, minimal enlargement of laparoscopic port sites to extract large, stone-filled gallbladders from the abdomen.

Methods

The study device consists of a handle with a retraction tongue to shield the specimen and a guide for a scalpel to incise the fascia within the incision. Patients enrolled underwent laparoscopic cholecystectomy. Gallbladder extraction was attempted. If standard measures failed, the device was implemented. Extraction time and device utility scores were recorded for each patient. Patients returned 3–4 weeks postoperatively for assessment of pain level, cosmetic effect, and presence of infectious complications.

Results

Twenty (51 %) of 39 patients required the device. Average extraction time for the first eight patients was 120 s. After interim analysis, an improved device was used in 12 patients and average extraction time was 24 s. There were no adverse events. Postoperative pain ratings and incision cosmesis were comparable between patients with and without use of the device.

Conclusion

The study device enables safe and rapid extraction of impacted gallbladders through the abdominal wall.

Olsen DO. Laparoscopic cholecystectomy. The American Journal of Surgery. 1991;161(3):339–344. doi: 10.1016/0002-9610(91)90592-2.CrossRef

Dreznik Z, Soper NJ. Trocar site abscess due to spilled gallstones: An unusual late complication of laparoscopic cholecystectomy. Surg Laparosc Endosc. 1993;3(3):223–224.PubMed

Battaglia DM, Fornasier VL, Mamazza J. Gallstone in abdominal wall—a complication of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2001;11(1):50–52.PubMed

Zulfikaroglu B, Ozalp N, Mahir Ozmen M, Koc M. What happens to the lost gallstone during laparoscopic cholecystectomy? Surg Endosc. 2003;17(1):158. doi: 10.1007/s00464-002-4242-1.PubMed

Sarli L, Contini S, Sansebastiano G, Gobbi S, Costi R, Roncoroni L. Does laparoscopic cholecystectomy worsen the prognosis of unsuspected gallbladder cancer? Arch Surg. 2000;135(11):1340–1344.PubMedCrossRef

Wullstein C, Woeste G, Barkhausen S, Gross E, Hopt UT. Do complications related to laparoscopic cholecystectomy influence the prognosis of gallbladder cancer? Surg Endosc. 2002;16(5):828–832. doi: 10.1007/s00464-001-9085-7.PubMedCrossRef

Kim JH, Kim WH, Kim JH, Yoo BM, Kim MW. Unsuspected gallbladder cancer diagnosed after laparoscopic cholecystectomy: Focus on acute cholecystitis. World J Surg. 2010;34(1):114–120. doi: 10.1007/s00268-009-0279-9; 10.1007/s00268-009-0279-9.

Bordelon BM, Hobday KA, Hunter JG. Incision extension is the optimal method of difficult gallbladder extraction at laparoscopic cholecystectomy. Surg Endosc. 1992;6(5):225–227.PubMedCrossRef

Sackier JM, Hunter JG, Paz-Partlow M, Cuschieri A. The rotary gallstone lithotrite to aid gallbladder extraction in laparoscopic cholecystectomy. Surg Endosc. 1992;6(5):235–238.PubMedCrossRef

10.

Bickel A, Szabo A, Shtamler B. A safe simple method for removal of the gallbladder through the umbilical trocar site during laparoscopic cholecystectomy. J Laparoendosc Surg. 1993;3(5):485–487.PubMedCrossRef

11.

Kanehira E, Omura K, Kawai K, Ishikawa N, Watanabe Y. A new extraction bag to facilitate stone extraction in laparoscopic cholecystectomy: In vitro experiments. Endosc Surg Allied Technol. 1994;2(6):297–299.PubMed

12.

John Hunter ST. Laparoscopic cholecystectomy, intraoperative cholangiography, and common bile duct exploration. In: Josef Fisher KB, ed. Mastery of surgery. 5th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2006:1116–1128.

Title: Design, Development, and Evaluation of a Novel Retraction Device for Gallbladder Extraction During Laparoscopic Cholecystectomy
Authors: Joshua M. Judge
George J. Stukenborg
William F. Johnston
William H. Guilford
Craig L. Slingluff Jr.
Peter T. Hallowell
Publication date: 01-02-2014
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 2/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-013-2292-4

At a glance: The STEP trials

Springer Medicine

Design, Development, and Evaluation of a Novel Retraction Device for Gallbladder Extraction During Laparoscopic Cholecystectomy

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2014

Role of Gastrografin Challenge in Early Postoperative Small Bowel Obstruction

Endoscopic Ultrasound Staging of Stenotic Esophageal Cancers May Be Unnecessary to Determine the Need for Neoadjuvant Therapy

Paradigm-Shifting New Evidence for Treatment of Rectal Cancer

Depth of Submucosal Tumor Infiltration and its Relevance in Lymphatic Metastasis Formation for T1b Squamous Cell and Adenocarcinomas of the Esophagus

Management of Acute Cholecystitis: Prevalence of Percutaneous Cholecystostomy and Delayed Cholecystectomy in the Elderly

Overexpressing TNF-Alpha in Pancreatic Ductal Adenocarcinoma Cells and Fibroblasts Modifies Cell Survival and Reduces Fatty Acid Synthesis via Downregulation of Sterol Regulatory Element Binding Protein-1 and Activation of Acetyl CoA Carboxylase