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NOTES platform
PICTURES
Transport
G Prox
G -‐ Cath
NAME of the products
IOP -‐ Incisionless Operating Platform
CODES
Transport ® Endoscopic Access Device – code 118180 USGI G-‐Prox ® EZ-‐33 Endoscopic Grasper – code 208220 USGI G-‐CathTM EZ Delivery Catheter with Snowshoe Suture Anchors – code 208100 USGI
G-‐Lix TissueTM Grasper – code 301010 USGI
MANUFACTURER
USGI Medical, San Clemente, CA, USA
DESCRIPTION
IOP consists of a 110 cm × 18 mm overtube-‐like design with a steerable shaft and several channels. The overtube-‐shaft is capable of stiffening, providing enhanced stability. Specifically designed tools enable the surgeon with enhanced manipulation capabilities and safe closure of entry site.
FEATURES
Its four channels (7, 6, 4 and 4 mm in size) allow for the passage of specialized equipment and a standard endoscope. The endoscope is independently rotatable within the channel allowing for an adjustable horizon while
G-‐Lix
maintaining instrument position. One channel can be used for high flow carbon dioxide insufflation.
G-‐Prox is a flexible but robust needle driver used to deliver G-‐cath Snowshoe Suture Anchors. The body of the device accurately conveys torque and the forces necessary to accomplish complex tasks in an incisionless fashion. The G-‐Prox can be loaded and reloaded with G-‐Caths without withdrawind or repositioning the instruments.
The g-‐Lix is an helical endoscopic tissue grasper designed to engace tissue securely. Its design consist of an easy torque-‐stable shaft and an ergonomic rotation handle that , when twisted, rotates the helix into tissue. The device allows exceptional forces especially in the tight spaces like oftnely found in natural orifice surgery.
UNIQUE DIFFERENCES (to other instruments) Enhanced deflection and stability of the platform together with improved capabilities of tissue manipulation and safe and easy viscerotomy closure
FURTHER READING:
http://www.usgimedical.com/
PICTURES
Anubiscope
Tip of the platform
Manipulator
NAME of the products
Anubiscope
CODES Not commercially available
MANUFACTURER
Karl Storz, Germany
DESCRIPTION
Flexible endoscopic surgical platform for advanced intraluminal and transluminal tissue manipulation
FEATURES
The flexible surgical platform is provided with a bivalve tip that opens once in the peritoneal cavity with flexible instruments passing through the working channels and exiting in a triangulated fashion. An independent channel holds the place for a small endoscope while lightening is provided by the flexible platform. The ergonomic handling of the instruments and the independent control of the tip of the platform allows for enhanced manipulation and suturing capabilities.
UNIQUE DIFFERENCES (to other instruments) Two hands manipulation in a triangulated surgical fashion
FURTHER READING:
http://www.karlstorz.de
PICTURES
EndoSamurai
Tip of the instrument
NAME of the products
Endosamurai
CODES Not commercially available
MANUFACTURER
Olympus Company, Japan
DESCRIPTION
Flexible operative platform with multiple degree of freedom of the end effector and intuitve hand control
FEATURES The distal end of the scope has two short modified independent arms, which upon entry remain parallel with the scope shaft, however, open in an elbow-‐like fashion when in position. With 5 degrees of freedom and triangulation capabilities, the arms can tie sutures as well as provide traction and counter traction. In addition to the two conduits, there is a third working channel that may be used for ancillary equipment or suction/irrigation. Stiffened by a locking overtube, the scope articulates in the same manner as a standard endoscope with identical visualization. Interestingly, this system employs a “drive, park and move” methodology. Where the user navigates to the target with the endoscope, locks the overtube system and scope in position and then proceeds to the user interface. This effectively allows one operator to perform most of the work load. As the arms are married to the camera/scope, it still bears the same image-‐perspective limitations as the standard endoscope.
UNIQUE DIFFERENCES
Intuitive, bi-‐manual interface to control instruments with multiple degrees of freedom
FURTHER READING:
www.olyympus.de
PICTURES
DDS
Tip of the DDS
NAME of the products
DDES – Direct Drive Endoscopic System
CODES
Not commercially available
MANUFACTURER
Boston Scientific, USA
DESCRIPTION
Flexible surgical platform with independent channel for endoscope and interchangeable instruments.
FEATURES It is a flexible-‐laparoscopic multitasking platform that consists of a 55-‐cm steerable guide sheath that houses 3 lumens extending from a rail-‐based platform with interchangeable 4 mm instruments. A unique system in the handle allows for seven degrees of freedom: surge, pitch, yaw, roll, tool action, heave and sway. Equipment currently available consists of graspers, scissors, needle pushers and cautery devices. These effectors can traverse a distance from the sheath tip independent of the image. While specialized tools are passed through channels in the guide tube, a standard endoscope can be used for visualization. The scope can rotate freely and positioned independent of the DDES end effectors. The sheath serves as a guide that can be “docked” once in position.
UNIQUE DIFFERENCES (to other instruments) Unique user interface that consists of ergonomic rail-‐guided drive handles situated above the surgeon’s waist that allow for seven degrees of freedom FURTHER READING:
http://www.bostonscientific.com/us
TEM PLATFORMS
Richard Wolf TEM Instrument System
PICTURES
Stereo Scope
Rectoscope tubes
Grasping forceps
Scissors
NAME of the products
Richard Wolf TEM Instrument System
CODES Stereoscope: 884080; Rectoscopes: 8840.021; Grasping forceps 8840.621; Scissors 8840.643 ; Monopolar Cautery 8840.711; Needle Holder 8840.605 ; Suction Tube 8840.731 ; U-‐shaped Support Arm 8840.9721
MANUFACTURER
Richard Wolf, Germany
DESCRIPTION
Transanal Endoscopic Platform for microsurgical removal of neoplasm of the rectum up to 20 cm.
FEATURES
3D visualization of the tissue, combination of pump/insufflator unit for controlled distension, specially angled hand instruments for precise excision and suturing of the tissue. Support arm to stabilize the platform to the operatory room table for confortable and precise manipulation of the tissue.
UNIQUE DIFFERENCES autoclavable 3D vision systems and pump/insufflator unit for controlled distension
Knife Monopolar
Needle Holder
Suture clip forcep
Suction Tube
U-‐shaped Support Arm
FURTHER READING:
http://www.richardwolf.com
Karl Storz TEO Platform
PICTURES
TEO complete platform
TEO short and long version
NAME of the products
TEO – Transanal Endoscopic Operations
CODES
MANUFACTURER
Karl Storz, Germany
DESCRIPTION
Operative Rectoscope for transanal operation
FEATURES
Operative rectoscope compatible with numerous standard laparoscopic tools as well as laparoscopic towers without any need to acquire dedicated unit.Connected to the operatory room table it offers a stable platform to operate transanally into the rectum uop to 20 cm from anal verge.
UNIQUE DIFFERENCES (to other instruments)
Available in different lengths up to 20 cm
Special connectors for CO2 insufflation, for effective telescope cleaning and for vapor evaporation
Ideal combination with standard 3 mm instruments
FURTHER READING:
www.karlstorz.com