Abstract Background Effective organ retraction in minimally invasive bariatric surgery remains challenging, often requiring additional assistants or multiple trocars, which increases procedural complexity, operative time, costs, and potential complications. Furthermore, traditional retraction methods can compromise visualization during critical steps like esophageal dissection and liver mobilization and may cause tissue trauma from excessive traction forces. To address these challenges, the Elastic Intracorporeal Retractor (EICR) (Changzhou XinNeng Yuan Medical Stapler Co., Ltd, AKA XNY medical) represents an innovative solution, deployed through standard 10 mm trocar, offering hands-free organ retraction through lightweight elastic construction with adjustable titanium staples designed for stable, atraumatic tissue manipulation. Despite promising design features, real-world surgical experience and usability assessment are essential for widespread device adoption in bariatric practice. Methods The objective of this retrospective multi-institutional study was to evaluate EICR deployment, setup characteristics, and usability during 30 consecutive bariatric procedures across two institutions. Procedures included Single Anastomosis Sleeve Ileal bypass (SASI), sleeve gastrectomy, sleeve plication, and other procedures, including cases with previous abdominal surgery. Primary endpoints were deployment success rates, setup times, and safety outcomes. Secondary endpoints included visualization quality and workflow integration into standard laparoscopic approaches. Results A total of 30 patients were included across both institutions with mean age 38.1 ± 13.6 years and mean BMI 38.0 ± 7.0 kg/m2. Procedures included SASI (47%), sleeve gastrectomy (27%), sleeve plication (17%), and other procedures (9%). Device deployment achieved 100% first-attempt success rate (30/30 cases) across all procedures. Setup typically required 1–3 min. The silicone retractor provided consistent, hands-free tissue manipulation without slippage during procedures. We observed clear, unobstructed visualization of surgical fields with the titanium hooks maintaining secure tissue contact throughout liver retraction in all cases, with one case requiring additional esophageal retraction. The device remained stable during insufflation changes and patient positioning adjustments. No device-related complications (0%), mechanical failures, organ injuries, or procedural delays occurred. No additional trocars were required for visualization in any case. The EICR effectively eliminated the need for additional surgical assistants for retraction purposes in 100%of cases, allowing improved surgical autonomy and enhanced workflow efficiency throughout our experience. Conclusion Our multi-institutional experience confirms EICR as an effective and reliable retraction solution in bariatric surgery, providing consistent stable visualization and excellent safety profile. The device enhances surgical workflow efficiency and reduces operative complexity without compromising.
Sleilati et al. (Thu,) studied this question.
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