Johnson & Johnson Institute
Total laparoscopic hysterectomy
Commonly used devices
Commonly used equipment
Laparoscopic equipment: 5-mm or 10-mm 0-degree laparoscope, atraumatic and traumatic graspers.
Generally other equipment is used and available as necessary: Electrocautery instrument (hook or spatula), suction-irrigator, uterine manipulator, laparoscopic needle drivers, knot pusher, vaginal occluder
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Insufflation needle
ENDOPATH™ Insufflation Needles
The ENDOPATH™ Pneumoneedle and Ultra Veress Insufflation Needles are surgical instrument used during minimally invasive procedures, particularly in laparoscopy, and are intended to establish pneumoperitoneum.1,2 The abdominal distension allows surgeons to see and operate on the internal structures more easily. Each device utilizes a spring-loaded, blunt stylet safety mechanism. Features of both devices include: 14-gauge stainless steel needle, attached at its proximal end to a plastic comfort handle containing a stopcock and a Luer lock connector for insufflating the abdominal cavity. The abdominal distension allows surgeons to see and operate on the internal structures more easily.1,2
Trocars
ENDOPATH XCEL™ Trocars
Trocars are the first point of contact into a patient during minimally invasive procedures and need to do many jobs - maximize visibility and maneuverability, enable surgical flow, and minimize exposure to pneumoperitoneum gas. ENDOPATH XCEL™ Trocars are designed to offer the control1,2A-D and consistency3-5E-G needed throughout the procedure from open to close.
Energy
MEGADYNE™ E-Z CLEAN™ Electrosurgical Electrodes
For use with electrosurgical pencils, the MEGADYNE™ E-Z CLEAN™ Electrosurgical Electrodes offer a non-stick PTFE coating that is designed to be easily cleaned with a damp sponge.1 These are available in multiple tips and lengths and produce 68% less smoke than uncoated stainless steel blades.2A
Energy
HARMONIC™ 1100 Shears
When operating in tight spaces or near vital structures, precision is essential. HARMONIC™ stands unrivaled as the undisputed ultrasonic leader and proven to deliver minimal thermal impact on tissue1,2A with precise energy delivery.3,4 HARMONIC™ 1100 Shears, our most advanced ultrasonic device, delivers secure vessel sealing up to and including 7mm5-7, faster transection speeds, lower maximum blade temperatures, and more precise tissue dissection.8-12B
Energy
ENSEAL™ X1 Straight Jaw Tissue Sealer
ENSEAL™ X1 Straight Jaw Tissue Sealer is designed to deliver secure sealing1A for open and laparoscopic surgical procedures. This device offers simplified steps optimized for one-handed2 360-degree rotation3-5, separate seal and cut buttons4-5, and an efficient, ergonomic grip.2B
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Energy
ENSEAL™ X1 Curved Jaw Tissue Sealer
The ENSEAL™ X1 Curved Jaw Tissue Sealer, a part of our advanced bipolar ENSEAL™ portfolio, delivers secure sealing.1A This device has a curved tapered tip, and features simplified steps for use with one-handed2, 360-degree rotation3-5, separate seal and cut buttons4-5, and an efficient, ergonomic grip.2B
Suture
Coated VICRYL™ Plus Antibacterial (Polyglactin 910) Suture
Surgical site infections (SSIs) are the most common type of hospital-acquired infection.1 Part of the Ethicon suture portfolio, Coated VICRYL™ Plus Antibacterial Sutures provide the same handling and performance as traditional Coated VICRYL™ (polyglactin 910) Sutures while dependably providing antibacterial protection.2-9
Coated with triclosan, these absorbable sutures were associated with nearly 30% reduction in the risk of SSIs10,11A Backed by the highest level of clinical evidence,8,12-16H these sutures offer an added layer of protection against the most common pathogens associated with SSIs in an in vitro study.2,4,5BC
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Suture
MONOCRYL™ Plus Antibacterial (poliglecaprone 25) Suture
Surgical site infections (SSIs) are the most common type of hospital-acquired infection.1 Part of the Ethicon suture portfolio, MONOCRYL™ Plus Antibacterial Sutures provide the same handling and performance as traditional MONOCRYL™ (Poliglecaprone 25) Sutures while dependably providing antibacterial protection.2-9
Coated with triclosan, these absorbable sutures were associated with nearly 30% reduction in the risk of SSIs.10,11A Backed by the highest level of clinical evidence,8,12-16H these sutures offer an added layer of protection against the most common pathogens associated with SSIs in an in vitro study.2,4,5BC
Topical skin adhesive
DERMABOND™ PRINEO™ Skin Closure System
The DERMABOND™ PRINEO™ Skin Closure System offers a powerful, non-invasive alternative to traditional skin sutures and staples. It offers strong, protected closure for optimal wound healing1-3 and protects against bacteria penetration.1A-C In a clinical study, the DERMABOND™ PRINEO™ System was associated with a better cosmetic outcome than conventional suturing in skin closure.4D
Barbed suture
STRATAFIX™ Spiral Barbed Suture
STRATAFIX™ is a portfolio of Barbed Suture products that offers a variety of barbed structure, polymers, and unidirectional and bidirectional designs to accommodate a wide variety of procedures. View device specifications for full portfolio offering.
STRATAFIX™ Spiral Barbed Suture represent the next generation of suturing devices, eliminating the need for knot tying while suturing.1,2 Fixating barbs allows you to maintain tension on each pass for more security, consistency, and efficiency than traditional sutures.3-11 Smooth tissue passage and a secure hold help you control tension and achieve excellent tissue approximation.1,3-8,12 Unlike non-triclosan-coated QUILL™ MONODERM™ and V-Loc™ 90 sutures, STRATAFIX™ has antibacterial protection—shown to inhibit bacterial colonization of the suture in an in vitro test.13,14A
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Barbed suture
STRATAFIX™ Symmetric PDS™ Plus Knotless Tissue Control Device
STRATAFIX™ Portfolio offers a variety of barbed sutures, polymers, and undirectional and bidirectional designs to accommodate a wide variety of procedures. View device specifications for full portfolio offering.
With a unique anchor design, STRATAFIX™ Symmetric PDS™ Plus Knotless Tissue Control Device is the only barbed suture appropriate for high-tension areas, such as fascia.1,2A The barbs are uniquely designed and provide maximum holding in soft tissue where PDS™ Plus Suture is commonly used, including in high tension areas such as abdominal wall fascia, knee extensor mechanism fascia during a total knee replacement, deep hip fascia used during a total hip replacement, deep lumbar fascia during spine surgery, closure of mini-laparotomy incisions in patients with BMI less than 30 kg/m², and ventral hernia fascial closure with mesh.3 It is a next generation suture device that eliminates the need for knot-tying or need for an assistant to follow the suture.4,5 In addition, STRATAFIX™ Devices are the only antibacterial barbed suture available worldwide.6B
References
For complete indications, contraindications, warnings, precautions, and adverse reactions, please reference full package insert.
Grace Chen, MD prepared this procedure guide on behalf of Johnson & Johnson and its affiliates. The procedure guide reflects the opinions of the individual presenter, and the steps described may not encompass the complete steps of the procedure. Additionally, other surgeons may prefer different techniques, approaches, etc., as individual surgeon experience in his/her clinical practice, as well as patient needs, may dictate variation in procedure steps.
Before using any medical device, review all labeling, including without limitation; the Instructions For Use (IFU), and relevant package inserts with particular attention to the indications, contraindications, warnings and precautions, and steps for use of the device(s).
This presentation is not accredited for CE/CME.
Grace Chen, MD is compensated by and presenting on behalf of Johnson & Johnson and its affiliates and must present information in accordance with applicable regulatory requirements.
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