Design: A case using articulating laparoscopic instruments in place of conventional laparoscopic tools in a routine laparoscopic ovarian cystectomy illustrated as an educational video.

Setting: Community hospital with standard laparoscopic set-up with surgeon and first surgical assistant. Video towers placed at each side by the patient’s thigh for optimal visualization. Patient placed in dorsal lithotomy in slight trendelenburg during the operation.

Patients or Participants: This patient was a 31 year old with imaging features concerning for a dermoid cyst undergoing a planned laparoscopic ovarian cystectomy.

Interventions: This educational video demonstrates the use of an articulating laparoscopic Maryland Bipolar instrument in real-time during an ovarian cystectomy case. The video shows the ability of this articulating instrument to move in angles that a conventional laparoscopic tool cannot.

Measurements and Main Results: NA

Conclusion:

Articulating laparoscopic instruments may serve as a bridge between conventional laparoscopy and robotic-assisted laparoscopy. These instruments mimic the ergonomics, dexterity, and control of a robotic arm while reducing cost associated with a robotic console and the need for additional training. Furthermore, the use of these articulating laparoscopic instruments provide access to surgeons who did not receive robotic training but would like to benefit from the advantages of robotic surgery. In this video, the surgeon uses the articulating laparoscopic instrument to confer to the shape of the cyst allowing for precise dissection of the cyst wall while reducing inadvertent intra-operative spill of cyst contents.