Furthermore, retained towels and sponges during abdominal surgery results in serious postoperative morbidity and potential mortality and risks the reputation of the surgeon and institution. Lap Pak was developed with the intent of decreasing these known consequences of sponges and towels when used for facilitating surgical exposure during

major abdominal surgery. Radical cystectomy with pelvic lymphadenectomy and urinary diversion is a major abdominal surgical procedure that requires cephalad packing of the abdominal content in order to gain access to the bladder and retroperitoneum. For this review, five high-volume urologic oncology this website surgeons were invited to participate in the first testing Inhibitors,research,lifescience,medical of Lap Pak. The surgeons agreed to perform five radical cystectomies Inhibitors,research,lifescience,medical using the device without any prior training sessions. Prior to the first procedure, the technique for intraoperative placement of the device was reviewed with the engineer who developed the device. Of the five surgeons investigating Lap Inhibitors,research,lifescience,medical Pak, four (80%) and three (60%) agreed with the premise that decreasing the

risk of retained foreign body and minimizing trauma to the bowel was a clinically significant potential benefit of Lap Pak, respectively. Overall, three surgeons (60%) had a favorable experience using Lap Pak. None of the surgeons had a negative impression of the device and two (40%) had a neutral impression. Overall, Lap Inhibitors,research,lifescience,medical Pak was used in 23 cases. Of these cases, Lap Pak successfully facilitated exposure in 14 cases (61%). Three (60%) of the surgeons indicated they would use Lap Pak routinely on future radical cystectomy

procedures. Two of the five surgeons were less enthusiastic about the potential benefits or the performance of the device. These surgeons used Lap Pak together with a Balfour retractor. The Balfour retractor has a single blade for cephalad exposure which may not be adequate Inhibitors,research,lifescience,medical to hold Lap Pak securely in place. Those surgeons using retractors that had two cephalad-oriented limbs all thought Lap Pak facilitated exposure and were both willing and enthusiastic about using the device on future cases. At the moment, Lap Pak comes in only one size primarily because of the limited else variability in the dimensions of the adult abdominal cavity. Based on preliminary experience, additional sizes may be required for patients at the extremes of BMI. We recognize that we cannot overgeneralize based on the view of only five surgeons whose experience may differ based on their level of expertise. Nevertheless, the generally favorable initial experience with Lap Pak provides the basis for further investigation of the device in order to optimize its use. It is likely that with further experience, minor adjustments will be made in the design or additional sizes will be required for its more universal role in abdominal surgery.