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From the 35th Annual Meeting - Las Vegas, Nevada- November 2006
Dr. Diesfeld: I am Patrick Diesfeld, an obstetrician/gynecologist in Ventura, California, and a long-time AAGL member and I have had an interest in laparoscopy and have enjoyed these meetings and increasing my knowledge through the AAGL forum. I am a clinical faculty volunteer for UCLA residency and have a surgery center in Ventura. I would like to introduce Dr. Mark Surrey. Mark Surrey is, of course, a fellow of the American College of OB/GYN, as well as a fellow of the American College of Surgeons. Mark is the director for the Center for Reproductive Medicine in Beverly Hills and is a professor of the Department of Obstetrics and Gynecology at the David Geffen UCLA School of Medicine. Mark has served as president of the AAGL in the past, as well as president of the Pacific Coast Reproductive Society and has authored numerous chapters and journal articles on laparoscopy and laparoscopic safety topics and is very active in in vitro fertilization. Mark, thank you.
Dr. Surrey: That is a lot, Pat. Thank you very much. Of all the introductions I have ever had, that is the most recent. You know, Pat, we are here to talk about some of the innovations at the laparoscopy meeting and this year I think what I am struck by is a couple things, one of which is very simple and it has to do with something that is very important to us as laparoscopic surgeons, but moreover, when we are say training people, and that is a small safety device. Would you like to, I know you have had a lot to do with the development of this device. Would you like to comment about how this came to you, this concept?
Dr. Diesfeld: Yes, I had been trained in laparoscopy from the start and had attended many post-graduate courses and had done some thousands of laparoscopies and then I had a vascular injury occur during a case and I regrouped and I spoke to Mark several times about what can we do to try to prevent these trocar injuries that we see published that are occurring to surgeons. They are occurring to surgeons in training, the new surgeons and also even the experienced surgeons at an incidence of trocar injuries of perhaps two to four per thousand. About 65% of those are vascular injuries and about 23% of those who incur a vascular injury will be a fatality. So it was a serious problem we decided to try to address and to find a mechanism to reduce the injuries.
Dr. Surrey: This had come to us as such a simple solution and I do not know if we can show this or not, but this is an example of a trocar and on the trocar, as you can see, there is a shield. This shield is something that can be adjusted to a different depth and prevent injury from its insertion. A lot of the newer trainees, the residency programs, are all dominated frankly by ladies that have small hands and, as such, when they insert trocars, it is a different mechanism of insertion that would be significantly benefited by a stop and this particular one has been deemed the Laparostop. It fits on all different sizes of trocars and there is a significant need for this type of a safety device. It is inexpensive, it is disposable and can be sutured in place and this is something that we have been so taken by that we have started a multi-center trial. Doctors from all over the world, ranging from Australia, South Africa, Europe and the United States, are now evaluating this device which we feel should and can be used on all laparoscopic trocars to maximize safety of trocar insertion.
Dr. Diesfeld: Very good.
Dr. Surrey: I think that we have the opportunity because of this large multi-center trial that is beginning to gather more and more data on this instrument that has FDA approval and this device is something that, as you can see, will be I think heard about in the future as a very important standard in safety in the United States and all over the world, not just for gynecologic surgery, but also for general surgery, laparoscopic surgeries of all types. Pat, thank you for having me.
Dr. Diesfeld: Thank you, Mark. Very nice.
Dr. Surrey: Thank you.
Dr. Diesfeld: Thank you.