ME328 Final Presentation (PDF)

A Novel MIS
Liver
Retractor

Suturing Technique

Umbilical Tape

Endograb

Normal Liver

Fatty Liver
Enhanced CT

Specific Aim # 1: Design a liver retraction
device that is both robust and MIS
compatible.

Hypothesis 1.3: A folding pattern with necessary joints will allow for insertion and setup of
a pre-assembled bracing structure and can be completed by a trained surgeon in
comparable or faster time than the current art of liver retraction technology.

Task 1.1: Design a bracing structure that distributes force across the peritoneum
and supports the liver at least 10 cm above the hiatus.

Initial Idea
Sketches

First
Prototype

Refined
Design
Second
Prototype

Task 1.2: Create a liver retracting device capable of fitting through a
standard 10mm MIS port.

Task 1.2: Continued

Initial Folding Mechanism
Prototype

3D Printed Prototype in
Insertion Configuration

CAD Model Of Device in
Insertion Configuration

Specific Aim # 2: Integrate post-insertion
control of the device so as to ensure the
surgeon can fine tune the shape of their
desired work space.

Hypothesis 2.2: Visual feedback from traditional MIS cameras is sufficient for the
surgeon to accurately finalize the device configuration using the control scheme
designed in Task 2.1.

Task 2.1: Implement remote actuation of the supporting legs of the
structure designed.

Prototype with gelatin tissue phantom

Extension and retraction of
linear actuators

Micro linear actuator

Specific Aim 3: Distribute tool-tissue contact area of
the device to reduce stress concentrations in
surrounding tissue.

Hypothesis 3.2: The device designed will sufficiently distribute force so as to not perforate
or otherwise damage the load bearing tissues of the peritoneum even under the increased
load necessary to support a fatty liver.

Task 3.1: Analyze and adapt primary loading
areas of the device so as to eliminate sharp
edges and maximize surface area of contact
within the limits imposed by the MIS insertion
procedure.

Surgical Trials

Surgical Trials
1.

Standardized procedure on
porcine cadavers using our
device

Surgical Trials
1.

Standardized procedure on
porcine cadavers using our
device

2.

Timed components of the
procedure with a focus on
insertion and setup

Hypothesis 1.3: The device can be assembled quickly

Surgical Trials
1.

Standardized procedure on
porcine cadavers using our
device

2.

Timed components of the
procedure with a focus on
insertion and setup

3.

Video review to assess
level of hiatal exposure

Hypothesis 2.2: Traditional MIS cameras are sufficient
feedback for positioning of the device

Palanivelu, Praveenraj, et al. "Review of various liver retraction techniques in single
incision laparoscopic surgery for the exposure of hiatus." Journal of minimal access
surgery 11.3 (2015): 198.

Surgical Trials
1.

Standardized procedure on
porcine cadavers using our
device

2.

Timed components of the
procedure with a focus on
insertion and setup

3.

Video review to assess
level of hiatal exposure

4.

Open cavity postoperative
inspection to quantify total
tissue damage

Hypothesis 3.2: The device will diminish stress
concentrations