Soft tissue protection from exposed K-wires

TECHNIQUE With the recent advent of single port laparoscopic surgery, a single access port (SILSTM; Covidien, Mansfield, MA, US) can be used to gain retroperitoneal access (Fig 1) and allow necrosectomy to be performed. During the procedure, irrigation with warmed 0.9% saline or low CO2 pressure (8mmHg) permits visualisation of the retroperitoneum, and standard laparoscopic graspers and a suction device can be placed through additional port sites in the unit to allow removal of necrotic tissue (Fig 2). Post-operatively, continued irrigation of the Figure 1 SILSTM port allowing access to the retroperitoneum