Single port manipulator for minimally invasive surgery

INTRODUCTION Although minimally invasive surgery has many advantages compared to open surgery, its performance is restricted due to technical limitations. Besides the development of new instruments, the current focus is set on trauma reduction by performing single port operations or transluminal surgery (NOTES) [1]. The development of instruments with enhanced flexibility is a major challenge and therefore intensively investigated by various research institutes [e.g. 2]. Usually, the intraabdominal flexibility of rigid laparoscopic instruments that is limited due to the entry port is augmented with additional distal articulations. NOTES operations depend to an even greater extend upon a suitable, newly designed single lumen universal tool [3]. The first approach devoted to this problem is the endoscopebased octopus system as developed by Swanstrom et al [4]. Anubis (Karl Storz, D) and Endosamurai (Olympus, J) are other NOTES platforms designed for transluminal surgery. However, these systems have a small operating range, limited flexibility and opposite or retroflective working is not possible. We developed the “Highly Versatile Single Port System” (HVSPS) to overcome these drawbacks. The idea is, literally spoken, to bring the surgeon’s head, shoulders and arms into the abdominal cavity to regain the flexibility of open surgery. The specific aim of this study is the evaluation of the HVSPS prototype for single-port laparoscopic cholecystectomy.