Laparoscopic choledochal cyst resection using a novel articulating instrument in pediatric patients

Background: Historically, choledochal cyst excision has been performed as an open procedure. Controversy remains regarding managing this technically challenging entity in a minimally invasive fashion. Methods: A novel mechanically-designed intuitive, articulating instrument is used to facilitate int...

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Bibliographic Details
Main Authors: Nathan S. Rubalcava (Author), Richard E. Overman (Author), Mercedes Pilkington (Author), Christa N. Grant (Author), James D. Geiger (Author), Marcus D. Jarboe (Author), K. Elizabeth Speck (Author)
Format: Book
Published: Elsevier, 2021-07-01T00:00:00Z.
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Summary:Background: Historically, choledochal cyst excision has been performed as an open procedure. Controversy remains regarding managing this technically challenging entity in a minimally invasive fashion. Methods: A novel mechanically-designed intuitive, articulating instrument is used to facilitate intracorporeal suturing when there is limited working space. The mechanical design of the three-axis Gimbal cuff facilitates intracorporeal suturing by providing intuitive wristed function to the surgeon by translating the surgeon's wrist movement to the end effector. Results: We describe the adoption of a novel articulating instrument to facilitate a primary hepaticoduodenostomy within the limited space of a pediatric porta and a redo hepaticojejunostomy. Conclusions: These cases demonstrate the use of a novel articulating needle driver to sew an intracorporeal bilio-enteric anastomosis which obviates the need for robotic technology while expanding a laparoscopic surgeon's armamentarium.
Item Description:2213-5766
10.1016/j.epsc.2021.101888