2005 SAGES Abstracts

EMERGING TECHNOLOGY LUNCH POSTER ABSTRACTS
SAGES 2005
TP028
A BREAKTHROUGH IN SURGICAL VIDEOSCOPE TECHNOLO-
GY, Matthew Fahy MS, Gina M Baldo BA, Joseph R Williams
MS, Olympus America, Inc.
The new Olympus LTF-VP 5mm Surgical Videoscope is a technological
breakthrough in imaging engineering. It utilizes
Olympus? unique EndoEYE technology, placing the CCD
(charged coupled device) at the distal end of the scope. The
resulting image is brighter with better color reproduction and
resolution than any conventional laparoscope. This is due to
the fact that the rod lens system of conventional laparoscopes
is thereby eliminated, along with all its inherent limitations.
Since fewer lenses are required, reflected noise that occurs at
lens surfaces is educed. Light absorption that typically occurs
inside the rod lens system is reduced, permitting bright, natural-color
imaging and a deep, focus-free depth of field. A wider
field of view presents more reliable orientation. Illumination
lenses are placed at the distal tip, facilitating the most appropriate
light distribution and contributing to a wider field of
view.
The distal tip is also deflectable (flexible) and provides unlimited
degrees of visual freedom - up to 100° in any direction.
This advanced deflectable design allows comprehensive
observation of regions such as lateral, luminal and en face
parenchyma. The deflectable tip design also allows areas to be
viewed more expansively than ever before, even providing the
capability of visualizing anatomical structures that were previously
inaccessible with conventional laparoscopes. The LTF-VP
Videoscope can be utilized through any access port 5mm or
greater, enhancing the surgeon’s ability to view the
anatomy from any desired perspective. Ergonomic progression
includes a newly designed control body and deflector
mechanism. The one-piece integrated design requires no manual
focusing, no assembly and rapid reprocessing, improving
product durability and reliability.
TP029
REAL-TIME 3-D MEASUREMENTS IN ENDOSCOPIC VIDEO
IMAGES; A NOVEL ALGORITHM AND POTENTIAL FOR
FUTURE DEVELOPMENTS., Amir Szold MD, Tel Aviv Sourasky
Medical Center, Tel Aviv, Israel
Aim: the use of a single stereoscopic sensor for video imaging
enables to appoint three dimensional coordinates to each
pixel. In order to develop machine ?understanding? of anatomical
landmarks an algorithm capable of measuring 3-dimensional
relative distances between key points is necessary.
Methods: An algorithm has been developed that is capable of
accurate 3-dimensional measurements during endoscopic procedures.
Results: The algorithm was incorporated into a stereoscopic
camera picture-processing unit. The resolution of the device is
scalable according to application needs and is the result of the
sensor resolution, distance and anatomical features. Currently
the measurements are done in real time, while the image is
frozen to increase accuracy.
Future developments: 3D measurements enable 3-dimensional,
real time picture analysis. This, in turn, is the theoretical
basis for registering the streaming video to archived data,
such as anatomical landmarks from anatomy pictures or even
archived patient data such as CT or MRI.
TP030
THE SHAPELOCK: A UNIQUE AND VERSATILE TOOL FOR THE
NEXT GENERATION OF DIAGNOSTIC AND THERAPEUTIC
COLONOSCOPY, Pankaj J Pasricha MD, Gregory B Haber
MD,Douglas K Rex MD,Gottumukkala S Raju MD, University of
Texas Medical Branch, Lenox Hill Hospital, Indiana University
Technology Objective: The ShapeLock? Endoscopic Guide
(USGI Medical, San Clemente, CA) is a tool that facilitates intubation
and provides a platform for next generation therapeutic
procedures.
Description of Technology: The ShapeLock? Endoscopic Guide
consists of two components. The first component is a
reusable, multi-link, flexible overtube with a squeeze-activated
handle. The second component is a disposable, sterile sheath
with a smooth external skin, a hydrophilic coated inner liner
and an atraumatic tip that is loaded onto the reusable component
prior to each use.
Method of Application: The endoscope is inserted into the
lumen of the ShapeLock and then inserted into the anatomy.
Once inserted, the ShapeLock can be converted from a flexible
to a rigid configuration without changing shape to stabilize the
colon and prevent painful and potentially dangerous looping.
Preliminary Experience:
1. Preliminary studies from multiple centers involving over 200
cases have shown that the ShapeLock device is safe and facilitates
colonoscopy. Typical shortening and straightening
maneuvers of the colon are not only feasible but appear to be
abetted with the flexible ShapeLock in place.
2. Pilot data has shown that the ShapeLock is useful in facilitation
of colonoscopy to the cecum in patients with redundant
colon in which previous colonoscopy was unsuccessful.
3. The device serves as conduit for rapid redeployment of the
colonoscope to facilitate removal of multiple large polyps
located in the proximal colon and also serves as a decompression
tube during prolonged procedures, thereby improving
patient comfort.
4. The ShapeLock provides a large and flexible conduit for
evacuation and removal of semi-solid material or blood. The
role of ShapeLock to enable conversion of an incomplete prep
to a ?clean colon? is being investigated. The ShapeLock may
also be useful to quickly prepare the colon in cases of colonic
bleeds in which immediate colonoscopy is indicated.
Conclusions/Future Directions: The ability of the ShapeLock to
be converted from a flexible configuration to a rigid one that
resists pushing forces represents a technological advancement
in colonoscopy. The safe application of forces much greater
than currently possible may enable the ShapeLock to assist in
the development of next generation therapeutic procedures.
Finally, a narrow-bore, longer length ShapeLock has the potential
to enable the use of smaller colonoscopes.
TP031
LAPAROSCOPIC ASSISTED ENDOSCOPIC RETROGRADE
CHOLANGIOPANCREATOGRAPHY: A NOVEL TECHNIQUE TO
TREAT CHOLEDOCHOLITHIASIS DIAGNOSED AFTER LAPARO-
SCOPIC ROUX-EN-Y GASTRIC, William R Silliman MD, Roger
A delaTorre MD,Steven Scott MD,Nitin Rangnekar MD,Steven
Eubanks MD, University of Missouri-Columbia
Abstract:
1.Objective of the Technology or Device:
Morbid obesity has become a significant health problem in the
United States. Many patients are undergoing surgical treatment
for their obesity and, there has been a significant
increase in the number of laparoscopic roux en y gastric
bypass operations performed. Symptomatic cholelithiasis is a
common problem in the morbidly obese population.
Cholelithiasis may present either prior to or after the obese
patient has had significant weight loss. Choledocholithiasis, a
complication of cholelithiasis, is frequently treated with ERCP.
Unfortunately, patients who have had a previous roux-en-y
gastric bypass are not candidates for endoscopic removal of
the common duct stones with ERCP. We describe a novel technique
used to treat choledocholithiasis in a patient who had
undergone a roux-en-y gastric bypass 6 weeks prior.
2.Description of the technology and method of its use or application:
Laparoscopic assisted gastrotomy was performed in the
bypassed stomach allowing access to the stomach and duodenum
with introduction of the endoscope through the abdominal
wall and into the anterior mid-body of the stomach near
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