State-of-the art minimally invasive interventions

In no other sector is evidence of medical progress greater than in surgery. The last two decades have been marked by an increase in minimally invasive interventions. Although conventional open surgery still remains important in a number of indications, the advantages of minimally invasive procedures have meanwhile been documented with scientific and clinical evidence. These include a procedure that causes less haemorrhaging, better visibility of the operating field - which is increased even more through the magnifying effect of the endoscope - shorter hospital stays, less postoperative pain and higher overall patient satisfaction.

In some surgical interventions, the advantages of open surgical methods can be combined with those of endoscopic surgery. In particular, endoscopic procedures have become standard for interventions within the abdominal cavity. Thus laparoscopy is used for the following procedures:

• Appendectomy
• Gastrectomy
• Colon surgery
• Hernias
• Bowel resection
• Fundoplication

Gold standard for cholecystectomy
Cholecystectomy is the most common intervention in abdominal surgery. In this case open surgery is indicated in the following circumstances:

• Adhesions
• Perforation of the gallbladder
• Gallbladder cancer
• Serious heart and lung diseases

In a majority of cases, the cholecystectomy is carried out with laparoscopy. The minimally invasive procedure is considered standard therapy.

Laparoscopic procedure
Access to the gallbladder can be established with a stab incision at the navel. The abdominal wall is raised through the insufflation of carbon dioxide which creates sufficient room to ensure visual quality with the endoscopic lens and the introduction and manipulation of instruments.

Procedures which require only one abdominal incision and allow several instruments to be introduced at the same time, the so-called laparo-endoscopic single-site (LESS) or single incision laparoscopic surgery (SILS), constitute further developments of standard endoscopy. These interventions generally leave no scars since the incision takes place at the navel. LESS or SILS surgery requires a port consisting of several channels enabling the surgeon to insert up to three instruments at the same time, even though there is only one incision.

Endoscopic ultrasound instruments: safe coagulation and cutting
Whichever procedure is selected, laparoscopic or single port surgery, the use of endoscopic ultrasonic instruments leads to even less haemorrhaging and faster results. Ultrasound energy is converted into thermal energy by means of vibrations and can thus be used for dissection and coagulation with very precise results.  

Advantages of the Söring ultrasonic instruments:

• Less haemorrhaging and therefore improved view of the operating site for the surgeon
• No visible formation of smoke
• Low-risk dissection and coagulation since there is no current flowing through the patient 
• Ergonomic handling
• Cost efficiency through reusability

Methoden