CELIOSCOPIC INTRAABDOMINAL RETRACTION - COMPARISON OF 2 MECHANICAL DEVICES

The proper utilization and safety of rapidly developing celioscopic in strumentation remains uncertain. A porcine model was developed for tes ting two different types of mechanical, intra-abdominal retraction dev ices. One instrument was inflatable, forming a broad compliant interfa ce 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 s pleen, ileum and liver in sequential fashion with pressure maintained for 10 min. Photographic documentation of the gross effects of retract ion was obtained along with histological sectioning of each portion of the involved viscera with controls. The retraction devices produced s mall contusions with punctate, petechial haemorrhages within the tissu e, with the tips of each capable of tissue laceration. On each organ, the balloon retraction device produced the least amount of gross and h istological damage, demonstrating iatrogenic injury directly attributa ble to device design.