CHALLENGING THE SURGICAL STATUS QUOJeffrey de Jong - November 26, 2019
Laparoscopic surgery was introduced when I was in my training years to become a surgical specialist. Minimal invasive techniques developed rapidly and the trend quickly caught on throughout the world. The current numbers of laparoscopic procedures is sky high.
And it’s not just a favoured technique by surgeons, gynaecologists and urologists are also performing their fair share of laparoscopic procedures.
In most cases multiple trocarts are used per minimal invasive procedure. In The Netherlands we are in the habit to suture the fascia of trocart incisions that measure 10 millimeters and more.
There are a few common practises when it comes to this;
You either place the sutures before introducing the trocart or you secure the fascia with Kochers and then place the sutures when the trocart has been removed.
Most surgeons I know use the back of a surgical forceps for safety.
They place the back of the forceps under the fascia and place the sutures through the fascia.
It is easy and fast. However, with this method there’s a potential risk of iatrogenic injury of the intestine.
That got me wondering; How can I perform this act in a safer and more secure manner?
Road to Success
I decided to challenge this surgical status quo and come up with a better solution to rid us of this particular risk. Not a task to be taken lightly.
It took quite some time and effort to figure things out.
The creation of the first prototype resembled a small spoon that you could place under the fascia.
But because of the spoon like cup it would sometimes fills up with blood that impaired my vision and still making it a ‘blind stitch’.
So I decided to put some holes in that ‘spoon’ to prevent blood from pooling in it. It’s safe to say, this model didn’t leave me with the desired result either.
I went back to the drawing board with the insights I had now gained.
My Eureka moment came when I thought of combining the two prototypes with our trusted forceps. This idea initially led to the creation of the Jeff.
Essentially the Jeff is a fine surgical forceps. However there is an opening at one half of the connecting parts at the end of the forceps.
When you put the back of this forceps halfway under the fascia, with the opening facing the surface, you even have vision under the fascia!
This small modification allows you to place your sutures safely and provides you with the certainty that you are not harming the intestines. A simple, yet efficient way to improve your surgical act.
When you have placed the suture safely on one side, you simply switch your forceps to the other side and place the opposite suture, again under clear vision. Knot the suture and you are done.
Using the Jeff doesn’t change our practical standard, it just makes it a lot safer.
On every surgical instrument set found anywhere in the world a surgical forceps is present. After all, it is one of the most basic instruments we use.
This version is a reusable, fine surgical forceps with a small modification.
You use it exactly like a regular fine surgical forceps, but the Jeff provides you with the extra option to use the end for safe closure of the fascia at the trocart opening.
At the risk of sounding like a Sales Rep, however intended as peer advice;
I recommend you to use this practical surgical forceps.
In the light of all the laparoscopic surgery tools (and the disposables) this surgical forceps is inexpensive and almost climate neutral.
The production of my invention is carried out by Medex. This is a fully certified and respected Dutch company with the highest quality and production standards.
Inquiries to order your hot of the press fine surgical forceps can be done through Medex as well.
See you inside the Global Surgical Society. Stay safe!
More information about Jeffrey de Jong
Besides being a respected Gastrointestinal surgeon Jeffrey is a profound solution thinker. He is always working on something that can be improved, within the surgical field and beyond.
He founded the Surgical Brain Box, an organisation that aims to practically innovate the surgical act. Reach out the Jeffrey is you have ideas and solutions yourself, but you are struggling on where to start.
Visit the Surgical Brain Box
Surgical specialists get in touch with Jeffrey inside PONSIST
If you are not a surgical specialist, you can reach out to him through LinkedIN