Читать книгу Small Animal Laparoscopy and Thoracoscopy - Группа авторов - Страница 145

GelPOINT Access System (Applied Medical Inc., Rancho Santa Margarita, CA)

A 2‐ to 7‐cm mini‐laparotomy incision is created in advance for insertion of the port (Video 6.1). This single‐port device consists of a wound retractor, GelSeal cap, and four 5‐ to 10‐mm cannulae. The wound retractor portion of this port provides 360° atraumatic retraction of an abdominal incision 2–7 cm in length. The wound retractor portion is required to be inserted initially by passing the inner flexible ring through the abdominal incision. The outer ring is then rolled until it reaches the incision causing radial retraction. The cannulae are inserted through the GelSeal cap, and the GelSeal cap is then fitted to the outer ring of the wound retractor. The insufflator tubing is then attached, and the abdomen is insufflated to 8–10 mmHg with carbon dioxide using a pressure‐regulating mechanical insufflator. There are several advantages to using this device: the wound retractor sleeve is able to accommodate the widest range of body wall thicknesses compared with other single‐port devices; the wound retractor portion can accommodate a 7‐cm incision, which can enable large tissue removal; and the GelSeal cap can be removed and reattached repeatedly during the procedure without compromising the ability to re‐insufflate the abdomen.