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The retractor is
an indispensable surgical tool without which no surgeon would attempt
an operation requiring tissue retraction for full visualization of a surgical
field. No such device exists for the gastroenterologist, who is faced
with the challenge of treating endoluminal lesions. Examples of such problems
include acutely bleeding ulcers with pumping visible vessels, large sessile
polyps sprawled along the thin colon wall, pedunculated polyps endowed
with thick vascular stalks, Mallory Weiss tears, or the flat and difficult
Barrett's. Then there are those lesions that the endoscopist of the future
will treat as interventional endoscopy continues to evolve. These include
suture line disruption following surgical anastomosis, closure of enteric
fistulae, colonic perforations and endoscopic transluminal intra-abdominal
surgery. At present, the only means to enhance visualization of a lesion
is through air insufflation, providing only a fleeting retraction, often
insufficient for proper visualization. Furthermore, continuous air insufflation
can cause painful abdominal distention, which may result in colon perforation.
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The Nakao EndoRetractor, invented to enable visualization of an endoscopic surgical site, consists of a PET balloon, 0.5 mm in diameter, fashioned into two delicate circular bodies vertically interconnected by three legs. When inflated, the device transforms into a rigid, transparent cage which takes on the shape the intestine. The retractor, pre-loaded in its collapsed form, is introduced through the working channel of a double-channel endoscope. Upon reaching the surgical site, it is inflated, opening the intestinal lumen. A polypectomy snare or another surgical device is then introduced through the second working channel and the lesion is treated. Once the operation is complete the retractor is deflated and removed along with the endoscope. Issued Patent |
Copyright © Granit Medical Innovations, LLC 2005 |