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Richard Wolf
B 775 LEVD XI12 GB

B 775 LEVD XI12 GB

Product catalog summary

Introduction
This document presents a new surgical procedure in pediatric surgery called Laparoscopic Single-channel Varicocele Dissection (LEVD). Unlike previous methods, this technique uses a single port for both the telescope and instrument set, developed through collaboration between PD Dr. med. Ulf Bühligen and Richard Wolf.

Indication
Varicocele testis affects 5-10% of young children, primarily on the left side, due to increased hydrostatic pressure and impaired drainage in testicular veins. Symptoms include thickened venous convolutes and a dragging ache in the groin.

Diagnosis
Diagnosis involves clinical investigation, ultrasound comparison of testicles, and Doppler vascular imaging with Valsalva’s maneuver. Surgical intervention is indicated by dilatation and reverse blood flow in testicular veins.

Method
The LEVD technique involves laparoscopic transabdominal vascular transection using a single-channel method to minimize trauma and avoid visible scarring. A 5.5 mm operation laparoscope with a 3.5 mm working channel is used.

Instrument Set
The procedure requires specially developed bipolar forceps for vascular dissection. The instrument set allows for expansion with additional trocars if needed, maintaining visibility with suction and irrigation functions.

Result/Assessment
The procedure is outpatient and well-tolerated, leaving no visible scar. Post-operative follow-ups show no wound healing disturbances, neurological issues, or hydrocele. Ultrasound confirms good blood supply and testicular development.

Operating Procedure

Initial Preparation: Local anesthesia is applied, and a mini-laparotomy is performed at the navel. Gas insufflation is done via a 5.5 mm trocar.
Assessment and Positioning: The abdomen is assessed, and the patient is positioned for optimal access.
Incision and Preparation: The parietal peritoneum is opened, and vessels are exposed using a dissector and bipolar grasping forceps.
Coagulation and Dissection: Vessels are coagulated and resected safely, ensuring no damage to surrounding structures.
Completion and Wound Closure: The procedure concludes with vessel dissection and wound closure using Vicryl threads.

LEVD System Overview
The system includes a fiberoptic telescope, lightweight trocar sleeve, and a 3.5 mm working channel. The instrument set comprises various modular and insulated tools for precise surgical intervention.

Conclusion
The LEVD technique offers a minimally invasive, effective solution for pediatric varicocele surgery, with excellent post-operative outcomes and no visible scarring.

Catalog excerpts

Laparoscopic Single-channel Varicocele Dissection (LEVD) Technique · Instrument Set · Implementation

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New technique in pediatric surgery The technique presented below is a new surgical procedure in pediatric surgery. By contrast with previous laparoscopic procedures, the surgeon only uses one port through which the telescope and instrument set can be inserted. A compact Operation Set was created for this innovative method in the course of cooperation between PD Dr. med. Ulf Bühligen and Richard Wolf. PD Dr. med. Ulf Bühligen Leipzig University Hospital Hospital and Clinic for Pediatric Surgery [email protected] Indication: Varicocele testis occurs in approximately 5 –10 of...

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Operating procedure Initial preparation Local application of 2 ml 1 % Carbostesin. The skin incision is a longitudinal incision in the navel (mini-laparotomy). Gas insufflation up to 8 mm Hg is carried out via the 5.5 mm trocar. A 5.5 mm operating laparoscope with integrated 3.5 mm working channel (Richard Wolf) is used. Other access passages and working trocars are not needed. Assessment and positioning The abdomen is assessed, the varicocele side and the opposite side are inspected, the ductus deferens is identified. The patient is positioned slightly inclined to the right in a head-down position....

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RCHRRD rTT^i The operation is concluded with complete vessel dissection and visible distance be- 5.1 Partial dissection 5.2 Complete dissection We use 3 x 0 Vicryl threads single button to close the peritoneum at the navel. We suture the main wound with 4x0 Vicrylrapid threads. We use short tension tapes posi- tioned longitudinally over the wound as a wound dressing. 6.1 Wound closure 6.2 Wound dressing After one week, no scar can be seen.

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LEVD – System Overview Fiberoptic telescope with 50,000 pixel image guide for unsurpassed image quality given the overall instrument and channel size 50,000 pixel image guide Light fibres 3.5 mm working channel Irrigation or insufflation connector Light cable connector 3.5 mm working channel for the use of 3.5 mm standard instrument set Extremely lightweight 5.5 mm plastic trocar sleeve with insufflation connector 5.5 mm Surgical Laparoscope Set comprising: Surgical laparoscope with 3.5 mm working channel, 0° viewing direction, silicate image guide (8920.401), seal (8920.311), seal cap (15176.020),...

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LEVD – System Overview Self-retaining plastic trocar sleeve, 5.5 mm, WL 105 mm, autoclavable, with insufflation stopcock, incl. membrane valve 89.103 (10 units) 8919.353 For introduction: Trocar, conical with blunt tip 8919.3511 Trocar, conical with sharp tip 8919.3512 Trocar, with pyramid-shaped tip 8919.3513 Atraumatic grasping forceps modular, double-action, ø 3.5 mm, WL 310 mm, insulated 8391.2044 Holding forceps "Babcock" modular, double-action, ø 3.5 mm, WL 310 mm, insulated8391.2554 Hook scissors modular, movable, ø 3.5 mm, WL 310 mm, insulated 8391.0143 Scissors "Metzenbaum" modular,...

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B 775 LEVD XI12 GB

B 775 LEVD XI12 GB

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