MIS - ROBOTIC - OPEN
Instruments for thoracic procedures
Long Bipolar Grasper
There are a couple choices for the bipolar energy dissection. I prefer to use bipolar, however monopolar is available. Intuitive has a Maryland, Curve Bipolar Dissector and Long Bipolar Dissector.
Hook
There are a couple choices for the bipolar energy dissection. The hook is useful in certain circumstances. I think it helps to control small vessel bleeding. Many utilize it even for precise LN dissection.
Tip-Up Fenestrated
This is the most usefull instrument for the 3rd arm and general retraction. Atraumatic to the lung tissue but consider utilizinf a Kittner Cigar in the grasper to help with retraction.
Vessel Sealer
This is the typical energy device like the Ligasure or Enseal. Divids up to 7 mm. I use it for small venous or arterial branches. Also useful for thymectomy and foregut procedures.
Cadiere
Left hand atraumatic grasper. Since it is blunt it assists in gentle dissection around vessels. There is the Force Bipolar varient that has a atraumatic setting and stronger grip (traumatic) with the addition of bipolar use.
SyncroSeal
This is Intuitive new energy device that is an extension of the vessel sealer line. We have not used it as of yet but hope to incorporate it as a dissector and sealer in one.
optional recommendations
Cigar Kittner
This is the most usefull instrument for the 3rd arm and general retraction. Atraumatic to the lung tissue but consider utilizinf a Kittner Cigar in the grasper to help with retraction.
LN Baglet
Glove tips are useful to insure that the LN doesn't get caught in the port or if dropped is easier to locate.
Local Needle
This is an aspirating needle used for navigational bronchoscopy, however it works quite well to inject 2-4 mL 0.5% Marcaine for a direct intercostal nerve block (Covidien 21G Aspirating Needle)
Red Rubber Lead
Easy on and off guide for the stapler. Placing this as a guide behind a vessel and with the stapler following behind inproved safety.
Hassan
Useful for foregut surgeries. There is a longer port as well for the higher BMI patients.