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Laparoscopic Camera Circon Corporation introduced the first medical camera in 1972. Laparoscopic camera is a very important instrument in laparoscopic surgery and should be of excellent quality. It is available having either single chip or three chips.

There are three primary colors red, blue and green. All colors are a mixture of the three primary colors in different proportions. The (CCD) Charge-coupling device (Chip) is an electronic memory that documents the intensity of light as a variable charge. CCDs are analog devices widely used in still cameras, camcorders and scanners to capture images. Their charges are similar to the shades of light for monochrome images or shades of red, green and blue when used with color filters. The camera containing three chips uses three CCDs, one for each of the red, blue and green colors respectively. The coupled in the name CCD is because the CCD is composed of an array of imaging pixels and a matching array of storage pixels that are coupled together. After the imaging array is exposed to light, its charges are quickly relocated to the storage array. While the imaging CCDs are being exposed to the next picture, the

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storage CCDs from the last picture are being read out a row at a time to the analogto-digital converters that transform the charges into binary data (0/1) to be processed. The camera system consists of two components: The head of the camera, which is attached to the ocular of the telescope. The controller, which is usually available on the trolley along with the monitor. Within the head of camera is an objective zoom lens that focuses the image of the object on the chip, and a CCD chip that sees an image taken by telescope . The CCD then converts optical image into an electrical signal that is sent through the camera cable to CCU (Camera control unit). The chip has light sensitive photoreceptors that generate pixels by transforming the incoming photons into electronic charges. The electronic charges are then transferred from the pixels into a storage element on the chip. A subsequent scanning at defined time intervals results in a black and white image with grey tones. Pixel is the smallest element of a light-sensitive device. Focusing of Laparoscopic Camera Laparoscopic camera needs to be fixated before inserting inside the abdominal cavity. At the time of focusing, the camera should be placed at a distance of approximately 10 cm away from the object for the 10 mm telescope, 5 mm for 5 mm telescope and 4 mm for 4 mm telescope, with an average distance of approximately 5 mm for all telescopes.

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Laparoscopic Morcellator It is highly desirable to limit the size of the entry incision during tissue removal procedures so that the trauma endured by the patient could be reduced. In the past, efforts to reduce the entry incision size depended on the tissue to be removed and the need for access to the tissue. The rapid removal of excised tissue from the abdominal cavity is facilitated by electromechanical morcellation systems. They are mostly used in laparoscopic myoma enucleation and in laparoscopic hysterectomy.

Earlier, the morcellation techniques known do not provide a cover for the cutting head or allow relative extension and retraction of the cutting head. Moreover, the known morcellators do not provide means, whether electrical or mechanical, to prevent the unintentional actuation of the morcellator cutting head. Therefore, there exists a need for an effective mechanical morcellator which provides a relatively movable cutting head and which includes the means to prevent the unintentional actuation of the morcellator cutting head. The morcellator of the present day development allows removal of tissue without the requirement for large entry slits.

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At present, a morcellator for removing large masses of tissues during laparoscopic procedures includes a rotationally fixed, axially movable inner tube disposed within a rotating cutting member. The cutting member is often disposed in the annular space between the inner tube and an outer tube. The inner and outer tubes and the cutting member present a substantially rigid tubular structure. A laparoscopic grasping instrument can be inserted through the lumen and draw tissue proximally into the rotating cutting member. The severed tissue is drawn into the fixed lumen of the inner tube, as a distal end of the cutting member severs tissue. This prevents the cutting member from twisting the severed tissue, thereby preventing any degradation of the surgeons control. A novel valve can prevent loss of insufflation gas when no instrument traverses the lumen. The valve is adapted for passing surgical implements distally, and also for passing large morsels of severed tissue proximally. A low cost, single-use, and highly effective morcellator structure can be provided by powering the cutting member with a standard Flex drive Cable Coupler. Features: Uncomplicated and time-saving tissue morcellation Riskless intra-abdominal morcellation of large tissues Power-Cut is operated by mains connection Maintenance-free world Power supply (100-240V) Motor, gear and morcellator tubes are connected by rapid coupling Ergonomically shaped handle guarantees optimal handling The only disadvantage of this equipment is the high cost of the disposable hand pieces.

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Laparoscopic Bipolar This device is an electrosurgical instrument used in laparoscopic surgery. More particularly, it is used in grasping vessels and vascular tissues with sufficient force between two bipolar jaws to seal the vessel or vascular tissues. The device consists of a handle having an elongated tube. The tube consists of first and second jaw members having electrically conductive sealing surfaces attached to the distal end which are movable from a first position for approximating tissue to a second position for grasping tissue there between. The handle may include a fixed handle and a movable handle in some types of bipolar devices. The laparoscopic instruments are inserted into the patient through cannula, or a port, that has been made with a trocar. The sizes of the cannulas range from 3mm to 12mm. Since smaller slits are preferred, the manufactures are confronted with a difficult challenge in designing instruments. Certain surgical procedures require cutting blood vessels or vascular tissues. This is a problem faced by the surgeons because it is difficult to seal blood vessels. It is possible to seal blood vessels using appropriate electrosurgical power curve, coupled with an instrument capable of applying a large closure force to the vessel walls. Vessel sealing is defined as the process of liquefying the collagen in the tissue so that it cross-links and reforms into a fused mass. It would be desirable to have a surgical tool capable of applying electrosurgical energy, capable of applying a large closure force to the walls and also capable of fitting through the cannula. A large closure force between the jaws typically

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requires a large moment about the pivot of each jaw. This is a problem as the first and second pins have a small moment arm with respect to the pivot of each jaw. Different types of laparoscopic bipolar devices are available in the market. Among which are tong type, rippled bar, X-handle, U-handle, modular handle, ruby forceps etc. Bipolar- rippled bar consists of electrode bars attached to the forceps. In modular handle, electrodes are easily fixed and can be rotated 360 degrees for accurate jaw orientation. The bipolar- X handle is used in pinhole surgery, band aid surgery, invasive surgery etc. These devices are designed by making use of

superior quality raw materials, obtained from the well-known retailers of the industry. Along with latest technology, these products enable accurate grasping of the tissue. Features of the bipolar devices are: Tough construction Ergonomic designs Sterilized Resistance against oxidization Easy maintenance

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Laparoscopic Needle Holder The needle holder is a very significant element for laparoscopic surgical procedures. It is one of the vital instruments essential for joining the tissues in order to repair the areas that have been cut or removed during reconstructive surgery. As a result, the patient can heal properly after the surgery. Mostly, all laparoscopic needle holders have one fixed jaw and one jaw that open by squeezing the handle. Similarly, the jaw closes by releasing the handle from its locked position. Ergonomic designs of these needle holders are a perfect fit for the surgeons hand. The designs also provide an easy release for the locking mechanism. Since the overall length of the instrument is very long, all laparoscopic needle holders are created with a locking mechanism handle to assure the security of the needle in the jaw of the instrument. The handles are straight with ratchet allowing good control for closing and opening of the jaws. The profile of the jaws provides precision and strength during the positioning of the needles. The jaws are also straight like regular needle holders for open surgery. Straight jaws provide ideal control of the needle for diverse types of closures. There are several types of Needle holders: Standard straight K-model H-model Left/Right curved Romeo

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The Romeo Needle Holder is one of the most useful needle holders. It is most useful because of its capability to self-right the needle. When the needle is held in the needle holder, either curved or straight, the needle stays in the same position. At this point, the surgeon must turn his or her hands in order to have the needle facing the correct direction to pass the suture in the area being reconstructed. However, when a needle is held by a self-righting needle holder it is forced into the upright position making the suture much easier to pass. This eliminates the surgeons need to turn the instrument approximately 180 in order to pass the suture properly. With less need to turn the instruments direction, less strain is put onto the trocar. This helps minimize the complications during the surgery. For example, the gas that was driven into the patients abdominal region is likely to escape during the procedure, giving the trocars room to be inserted without damaging the patients vital organs. Usually the basic material used in the manufacturing of the needle holders is high grade stainless steel. Features: Strong construction Ergonomic designs Sterilized Resistance against corrosion Easy to use

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Laparoscopy virtual Endo Trainer: Laparoscopy virtual Endo Trainer is specifically designed for enabling a picture which looks almost like the picture taken using a laparoscopic camera. The regular laparoscopic video camera, light source, telescope and fiber optic cable are not necessary. Virtual endo trainer includes built in camera, light source, telescopic rod and virtual trocars. Along with this, the device is provided with plastic plate with holes for specimen holding. Three virtual trocars are provided to introduce the telescope and hand instruments.

Design The innovative virtual Endo Trainer is conceptualized, designed and developed to offer high resolution pictures which are as accurate as laparoscopic camera. Laparoscopy virtual endo trainer is a powder coated sheet metal box which looks similar to the human abdomen in shape and contains 3-5 holes for the instrument and telescope. The top cover of the sheet metal box has been hinged on one side and other side there is an open provision for holding the specimens.

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The CCD Camera is fixed on one end of the telescopic rod which passes through the trocar hole. At the other end of the telescopic rod the hand grip is attached. Due the hand grip, chances of falling of the telescopic rod are nil. Movement arrest clamp is provided to control the movement of the telescope. Telescopic Zoom-in and Zoom-out movement enables the personnel to keep the camera position as per the requirement. There is provision for not using the movement arrest clamp also. The video output of the camera can be taken through sealed cables present inside the endo trainer box. It is then connected to a socket. The output of the camera can be obtained from the socket and can be connected to the respective monitor. For illumination purposes, a pencil bulb has been built inside the Endo trainer box. All the electrical wires and other adapters are obscured from general view. All electrical connections are present inside the trainer box. The connection sockets for video system are located in the rear side of the control unit.

Features: Built-in CCD camera which provides high resolution color pictures which eliminates the need for regular Laparoscopic camera. The telescopic rod will aid the movement of the camera. The zoom in, zoom out, Left, Right, Up and Down movements are possible. Built in pencil tube light sources eliminates the use of regular laparoscopic light source & Fiber optic cable. Compact, ergonomic & most economic design. Longer serviceability

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Robust construction Efficiency

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Laparoscopic light source - Halogen With the technology development in laparoscopic surgery, imaging has undergone tremendous development. One of the advantages of the laparoscopy is that of obtaining a virtually micro-surgical view compared to that obtained by laparotomy. Whereas in fact at present, this view has become optoelectronic. Quality of the image obtained very much depends on the quantity of light available at each step of optical and electronic system. It is easy to say that, life is impossible without light. Without light there can be no laparoscopy. The light source is the often-overlooked soldier of the video laparoscopic system. High-intensity light is obtained using bulbs of halogen gas, xenon gas or mercury vapor. The bulbs are accessible in different wattages (150/300 watts). The wattage is chosen depending on the type of procedure being performed. Since blood absorbs light, any procedure in which bleeding is encountered may require more light. We use the stronger light sources for all advanced laparoscopy. Availability of light is a challenge in many bariatric procedures where the abdominal cavity is large. A good laparoscopic light source should emit light as much as possible. A typical light source is consist of A lamp A heat filter A condensing lens and Manual or automatic intensity control circuit. The quality of light is determined by the lamp used. Three types of light source are mostly used today:

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1. Halogen light source 2. Xenon light source 3. Metal halide light source The output from the light sources is directed to the telescope by light cables that contain either glass fiber bundles or special fluid. Lamp or bulb is the most important part of the light source. The halogen light source is used in the medical field since last 20 years. Halogen bulbs provide a highly effective, almost crisp white light source with excellent color rendering. Halogen lamps consist of electrodes made of tungsten; this is the only metal with a sufficiently high melting temperature and sufficient vapor pressure at elevated temperatures. They use halogen gas allowing bulbs to burn more intensely without sacrificing life. Halogen bulbs are low voltage and have an average life of 2,000 hours. Color temperature of Halogen lamp is (5000-5600 K). These lamps are economical and can be used for laparoscopic surgery if low budget setup is required. Features: Perfect Optical Collimator for getting maximum light. Intensity can be varied as per the requirement through Electronic Control. Ideally suited for all Endoscopic procedures including Laparoscopy. In-built Filter. Bright Light for Video applications. Easy Lamp replacement. Low-cost replacement lamps. Compact & Light Weight.

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About Author: Started in the year 2003, Hospiinz International is an excellent manufacturer and exporter of a wide variety of Laparoscopic Equipment and Laparoscopic Instruments. Its ISO 9001-2008 and ISO 134852003 certification speaks for the quality and expertise of the company in medical equipment field. The Organization conducts various tests on different parameters to assure the quality of products.

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Address : Mr.Mahendran (Managing Director) Old No.52/3, New No.8, Sarojini Street No.3, New Siddhapudur Coimbatore - 641 044, Tamil Nadu, India Website http;//www.hospiinz.com