Celioscopic intra-abdominal retraction: Comparison of two mechanical devices

Abstract

The proper utilization and safety of rapidly developing celioscopic instrumentation remains uncertain. A porcine model was developed for testing two different types of mechanical, intra-abdominal retraction devices. One instrument was inflatable, forming a broad compliant interface for tissue retraction. The second device consisted of three rubber-shod metal arms which formed a rigid, non-contiguous sweep. Each intra-abdominal device was placed with identical manual traction upon the spleen, ileum and liver in sequential fashion with pressure maintained for 10min. Photographic documentation of the gross effects of retraction was obtained along with histological sectioning of each portion of the involved viscera with controls. The retraction devices produced small contusions with punctate, petechial haemorrhages within the tissue, with the tips of each capable of tissue laceration. On each organ, the balloon retraction device produced the least amount of gross and histological damage, demonstrating iatrogenic injury directly attributable to device design.

Key Words:

• celioscopy
• retraction
• organ injury