Endoscopic surgery has conditions that are different from open surgery, insofar as the need for specific instrument design exists. Instruments for endoscopic surgery are introduced through round trocars with round seals, which means that they are basically always constructed in form of tube-like structures, allowing gas-tight sealing when the instruments are introduced [1].

Further specific conditions exist because of the limited degrees of freedom [2] when an instrument is introduced through a normal trocar sleeve. This means, for example, that needles for sutures cannot be guided in the optimal way. The conditions for the placement of endoscopic instruments often result in a nonergo-nomic working position so that the surgeon does not have optimal conditions for the work. Compared with open surgery, the possibility of using ligatures to transect vessel guiding structures is limited, as is the possibility of achieving hemostasis when bleeding occurs.

An increasingly important part of endoscopic surgery is endoluminal surgery. In addition to the points abovementioned in endoluminal surgery, for example in the rectum cavity, we are forced to work in a small working space, and the ability to introduce different instruments at the same time is limited because of the small space and the limited access [3].

0 0

Post a comment