Grasping soft tissue by means of vacuum technique

Introduction: A notable characteristic of bariatric surgery is the frequent manipulation of the bowel. The bowel is large, delicate, flexible, and has a natural lubricant on the tissue surface. Therefore the bowel is difficult to grasp and manipulate. Vacuum technique is commonly used in industry for all types of grasping and manipulation. Two types of nozzles that differed slightly in geometry (NT1 and NT2), were reviewed in an experimental set up for pull tests on pig bowels. Materials and methods: An experimental set-up was used to conduct a series of pull tests on pig bowel tissue. The basic principle of the measurements was a Newton's force balance; FPmax= Δp × A. Student t-tests, two-way ANOVA and Wilcoxon signed rank tests were conducted for the statistical analysis of NT1 and NT2 with regard to the maximum pull force (FPmax). Results: Concerning NT1 the Newton's force balance could not be confirmed. Concerning NT2 the Newton's force balance could partly be confirmed. For both nozzle types the effect of Δp on FPmaxwas significant. FPmaxincreases linear in proportion as Δp increases. This relation between FPmaxand Δp was confirmed by the Newton's force balance. Discussion: The results confirm that vacuum technique can be used as a grasp technique for soft organs, particularly the bowels. By means of a clever design of the nozzle a firm grip can be obtained on the bowel segments. Therefore vacuum technique should be studied for further development of instruments, graspers and retractors, to be used in the abdominal area.

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