With the development of advanced surgical techniques and instruments, video-assisted thoracic surgery has been broadly applied. During video-assisted thoracic surgery, commercialized disposable incision protectors are widely used. Incision protectors protect the operating incision, improve visibility for the operation, facilitate specimen removal, and reduce the risk of incision infection (1,2). Although commercialized disposable incision protectors offers many benefits, commercialized disposable incision protectors are often associated with high unit cost of about USD 160. Therefore, in the present study, we introduce a custom-made incision protector for thoracoscopic surgery that is more convenient in its utilization and inexpensive.
Our custom-made incision protector for thoracoscopic surgery comprises two stainless steel wire rings (a keyring can be purchased online as cheaply as USD 0.15, or the ring can be made from vein puncture guide wire) and surgical gloves (Figure 1A). First a surgical glove was cut to form a tube. The end of tube with the rubber band was passed through a stainless steel wire ring (30 cm in circumference) and turned inside-out (Figure 1B). The other end of the tube was advanced into another stainless steel ring (26 cm in circumference) and turned inside-out (Figure 1C). Thus, a custom incision protector for thoracoscopic surgery was made (Figure 1D). Only 3 to 5 minutes were spent on making the protector. When the custom-made incision protector was used, the 30-cm ring was placed intrapleural and the 26 cm in circumference was placed extrapleural (Figure 2).
Herein, we also introduce a technique to facilitate shortening the custom incision protector to an appropriate length using four scalp clips (Figure 3A,B). Attached to the outside of the incision protector, the four scalp clips can be rolled to shorten the protector to an appropriate length. In addition, condoms can be used instead of gloves to make the custom incision protector (Figure 3C).
From 34 cases, there were no reports of incision infections, incision disunions, and tumor implantation at 8 months of follow-up.
Although commercialized disposable incision protector offer many benefits, they are often associated with high purchase cost. We have also experienced poor elasticity in the two flexible rings of currently used commercialized disposable incision protectors. This made it difficult to place in the intercostal space, particularly in those patients with small intercostal spaces. Therefore, in the present study, we made an incision protector for thoracoscopic surgery that is much more convenient in its utilization and inexpensive.
The custom-made incision protector made from two stainless steel rings and a surgical glove. Assembly is simple and the stainless steel rings and surgical gloves can be acquired at a low price. Our custom-made incision protector can be made and immediately used in the operating room as long as there are surgical gloves and stainless steel wire available. In addition, the stainless steel wire can be repeatedly disinfected and reused. Thus, the consumption of materials is reduced. Custom-made incision protectors can be wildly applied because they are easy to use and inexpensive. The current price of a commercialized disposable incision protector is about USD 160 whereas our custom-made incision protector is approximately USD 1. There is a potential concern that stainless steel wire rings easily detach from the rubber. On the contrary, with our custom-made incision protector we found this is does not happen easily. Compared with commercialized disposable incision protectors, our custom-made incision protector provides similar effectiveness at a lower price and with better usability.
Our custom-made incision protector is as effective as commercialized disposable incision protectors but inexpensive and easier to use.
Funding: This research was supported by the Department of Health of Guangxi Zhuang Autonomous Region of China (No. S2016179).
Conflicts of Interest: The authors have no conflicts of interest to declare.
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Cite this article as: Mo A, Feng Z. Custom-made incision protector for thoracoscopic surgery. Video-assist Thorac Surg 2017;2:22.