Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1738, USA.
J Endourol. 2011 Jan;25(1):119-22. doi: 10.1089/end.2010.0199. Epub 2010 Oct 26.
The AirSeal™ access system is a novel laparoscopic trocar that uses airflow to create insufflation pressure without the need for a physical seal or valve. By eliminating all valve elements within the lumen of the canula, the port provides a platform that accommodates multiple instruments of any diameter, shape, or combination and is ideally suited for laparoendoscopic single-site surgery (LESS). We present our initial experience with valveless trocars in traditional urologic laparoscopic cases and a porcine LESS nephrectomy series.
Nine transperitoneal LESS nephrectomies were performed in a live porcine model using the 27-mm oval valveless trocar. All working instruments were placed through the single port, and the specimen was extracted through the 4-cm port site.
All cases were completed without technical or operative complications. The porcine single-port nephrectomy (n=9) was successfully performed in a mean operative time of 24 minutes through the single 27-mm oval trocar. This accommodated a 5-mm laparoscope, multiple 5-mm instruments, the Endo GIA stapler, and the 15-mm Endocatch bag without loss of insufflation pressure. Condensation and smudging of the laparoscope were minimized, improving visualization and efficiency. The system allowed for use of suction without significant loss of insufflation pressure.
The initial experience with the AirSeal valveless trocar system in LESS is encouraging. This technology may offer significant benefits over traditional laparoscopic trocars and single -port platforms and appears particularly suited to facilitate LESS.
AirSeal™ 通道系统是一种新型腹腔镜套管，它利用气流产生充气压力，而无需物理密封或阀门。通过消除套管管腔内部的所有阀门元件，该端口提供了一个平台，可容纳任何直径、形状或组合的多种器械，非常适合腹腔镜单部位手术（LESS）。我们介绍了在传统泌尿外科腹腔镜病例和猪 LESS 肾切除术系列中使用无阀套管的初步经验。
在活体猪模型中使用 27mm 椭圆形无阀套管进行了 9 例经腹腔的 LESS 肾切除术。所有手术器械均通过单端口放置，标本通过 4cm 端口取出。
所有病例均无技术或手术并发症。通过单个 27mm 椭圆形套管成功完成了 9 例猪单端口肾切除术，平均手术时间为 24 分钟。该套管可容纳 5mm 腹腔镜、多个 5mm 器械、Endo GIA 吻合器和 15mm Endocatch 袋，而不会降低充气压力。腹腔镜的冷凝和模糊度最小化，改善了可视化效果和效率。该系统允许使用抽吸而不会显著降低充气压力。
LESS 中使用 AirSeal 无阀套管系统的初步经验令人鼓舞。该技术可能比传统腹腔镜套管和单端口平台具有显著优势，并且似乎特别适合促进 LESS。
