Treatment-related adhesion morbidity includes difficulty with postoperative interventions such as intraperitoneal chemotherapy, radiation, and subsequent complications during repeat operations. Good surgical technique was advocated as the main way to prevent postoperative adhesions. reference 2 This included strict adherence to the basic surgical principles of minimizing tissue trauma with meticulous hemostasis, minimization of ischemia and desiccation, and prevention of infection and foreign body retention. The ideal adhesion barrier should meet the following criteria: (1) achieves effective tissue separation; (2) has a long half-life within the peritoneal cavity so that it can remain active during the critical 7-day peritoneal healing period; (3) is absorbed or metabolized without initiating a marked proinflammatory tissue response; (4) remains active and effective in the presence of blood; (5) does not compromise wound healing; and (6) does not promote bacterial growth.
Footnotes Dr. Gonz��lez-Quintero has disclosed affiliation with Genzyme. Dr. Cruz-Pachano has no disclosures to report.
A member of the Reviews in Obstetrics & Gynecology editorial board reviewed the following devices. The views of the author are personal opinions and do not necessarily represent the views of Reviews in Obstetrics & Gynecology or MedReviews?, LLC. Companies can submit a product for review by e-mailing [email protected]
Design/Functionality Scale 1 = Poor design; many deficits 2 = Solid design; many deficits 3 = Good design; few flaws 4 = Excellent design; few flaws 5 = Excellent design; flaws not apparent Innovation Scale 1 = Nothing new 2 = Small twist on standard technology 3 = Major twist on standard technology 4 = Significant new technology 5 = Game changer Value Scale 1 = Added cost with limited benefit 2 = Added cost with some benefit 3 = Added cost but significant benefit 4 = Marginal added cost but significant benefit 5 = Significant cost savings Overall Scale 1 = Don��t bother 2 = Niche product 3 = Worth a try 4 = Must try 5 = Must have Design/Functionality: 3.5 Innovation: 3 Value: 4 Overall Score: 4 Background As laparoscopic surgery has shifted in scope from diagnostic and simple therapeutic procedures to increasing operative complexity, the ancillary tools used to safely and efficiently accomplish these tasks has evolved in tandem.
Where a sponge stick, Jarcho cannula, or a Hulka tenaculum once sufficed as uterine manipulators, technical needs AV-951 have pushed for better devices with broader functionality. Seeking to address these needs, ConMed Endosurgery (Utica, NY) offers the VCare? Uterine Manipulator/Elevator. Design/Functionality As described in the company��s product literature, ��[the] VCare features a specially designed double-cup system; the forward cup displaces the cervix away from the ureters, retracts the urinary bladder and defines the colpotomy incision.