Conventional key hole surgery uses multiple “ports” – tiny holes through the abdominal wall, as many as 5 or even 6 in some procedures. With OCCTOPUS’ support the team have developed a simple cheap version of a single port. Commercially available devices cost around £400 and are a soft plug – about 4cm in diameter with ports pushed through it. The hands have to be close together and the single ports are rather clumsy. We have devised a glove port and this is essentially what is sounds like. A surgical glove is attached to a circular wound protector placed in the 3 cm long single incision.
Individual “fingers” can be cut to tie in ports which are very flexible and moveable. This is an elegant solution, is readily available and costs around £40. The availability and low cost are important because the technique can be used without serious preparation. Single port surgery using the glove port is being used for colon and rectal operations and the patient has one small incision.
Lymph Node Mapping and Perfusion
During a laparoscopic (keyhole) operation the abdomen is a closed tent like space illuminated by the camera optic. The light can be changed from ordinary white light and one particular application is fluorescence. A fluorescent chemical can be injected around a tumour inside the bowel and this flows along lymph channels to the local lymph glands or nodes. With the correct wavelength in the camera light, the glands show up as a chain of beads showing up brilliantly in a way they cannot be seen ordinarily. These glands could then be marked or removed to see if there is cancer in them whilst the operation is taking place. This usually happens afterwards. The same chemical could also be injected intravenously and the special camera can show up the blood vessels and quality of the blood flow in colon about to be joined together and perhaps prevent a faulty join being made and reducing the risk of leakage.
Both of these techniques are at the very cutting edge of surgical technology and OCCTOPUS has helped with securing leading technology partners to advance this work.