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