The Endofreeze System

This system is designed to perform solo surgery. It is a very simple construction, which allows one to hold the camera or to hold retracting instruments. The position of camera or instruments can be changed against a cer tain friction with only one hand, and it stays automatically in the new position.

Figure 12.11 shows the ball trocar. The system itself was developed by Tübingen Scientific, and production and marketing is performed by Aesculap [12]. The ball trocar has always to be inserted until the ball touches the abdominal wall to achieve a good position of the invariant point. The screw at the shaft of the trocar and the screw at the metal ring holding the ball allow an adjustment of the friction so that a movement to a new position is possible with the use of only one hand, and that the new position is kept stabile by the optimal defined friction.

Figure 12.12 shows the routine application of solo surgery in cholecystectomy. The camera and the retracting forceps are held by two ball trocars, linked to the operative table by a Leila retractor (Aesculap). With the right hand, the surgeon is guiding a combination instrument, with the left hand, the curved grasper that again, allows an optimal ergonomic working position and a good angle inside the abdomen between the tips of the instruments. Setup and positioning time by the use of Endofreeze both with the use of a Leila or Unitrac retractor comes close to the time needed in a conventional control group. They are clearly faster than any other advanced electronic camera-guiding systems [13]. Endofreeze in a way similar to the radius system fulfilled the task—to have simple tools available that are not too expensive, so that they can easily be used in routine surgery.

Fig. 12.12 Solo surgery of a cholecystectomy with the use of two endofreeze systems. On the right side of the patient a 5mm instrument for retraction of the gallbladder. At the umbilicus is a 10-mm ball trocar for holding the camera. Ergonomic working position of the surgeon due to the use of a curved window grasper

Fig. 12.12 Solo surgery of a cholecystectomy with the use of two endofreeze systems. On the right side of the patient a 5mm instrument for retraction of the gallbladder. At the umbilicus is a 10-mm ball trocar for holding the camera. Ergonomic working position of the surgeon due to the use of a curved window grasper

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