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- Title
Liver retraction system by C3-muco-adhesive polymer films for laparoscopic surgery.
- Authors
Aldeghaither, Saud; Tang, Benjie; Alijani, Afshin; McLean, Donald; Wright, Emma; Wang, Zhigang; Tait, Iain; Cuschieri, Alfred
- Abstract
<bold>Background: </bold>Conventional laparoscopic instruments used for retraction may cause trauma at the retraction site. Alternative retraction/lifting especially of heavy solid organs such as the liver may be obtained by other means. The present study was designed to explore the use of C3-muco-adhesive polymers (C3-MAPs), which exhibit strong binding to the liver shortly after application to the organ and which retain strong adhesion for sufficient time, to enable sustained retraction during laparoscopic operations.<bold>Methods and Materials: </bold>C3-muco-adhesive polymers were produced specifically for the study. In an ex vivo experimental set-up, discs of C3-MAPs were placed on the surface of porcine livers for adhesion and retraction studies involving objective measurements by tensiometry.<bold>Results: </bold>Experiments were carried out on 14 porcine livers. The force required to detach the C3-MAPs from the liver exceeded 2.0 N 30 s after application. The adhesion force by C3-MAPs files was sufficient to enable sustained retraction force necessary for exposure of the gall bladder, which was achieved by a mean retraction force of 4.85 N (SD = 0.63). This was sustained for a mean of 130 min (range 17.0-240.0). In the adhesion studies, the forces at 30 s required to detach the polymer discs from the liver exceeded 20 N (upper limit of the load cells of the Instron). The duration of the adhesion enabled sustained optimal gall bladder exposure for periods ranging from 17 to 240 min, with a mean of 130 ± 91 min.<bold>Conclusions: </bold>The results of the present study demonstrate that the adhesion and retraction properties of the engineered C3-MAP films are sufficient to enable complete exposure of the gall bladder for a period exceeding 1 h, confirming their potential for atraumatic retraction in laparoscopic and other minimal-access surgical approaches.
- Subjects
LAPAROSCOPIC surgery; POLYMER films; ADHESION; POLYMERS; TENSIOMETERS; BILIARY tract; CELLULOSE; ADHESIVES in surgery; ACRYLATES; ABDOMEN; ANIMAL experimentation; LAPAROSCOPY; LIVER; MECHANICS (Physics); SWINE; THERAPEUTICS
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2016, Vol 30, Issue 7, p2834
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-015-4563-5