This is a short introduction to operation of the Model DD1 Differential Dissector for open surgery. (Total time = 0:38)
Brachio-basilic Fistula
This is a video from Dr. Jeff Kaplan showing creation of a brachio-basilic fistula (human clinical use). Dr. Kaplan uses the DD1 for mobilization of the vein and artery and for subcutaneous tunneling. Note how easily the tunnel is formed and, more importantly, that it is created immediately under the dermis without dipping into subcutaneous tissues. This puts the transposed basilic vein immediately under the dermis, providing access for dialysis along the entire length of the vein. (Total time = 2:50)
Mobilization of an Artery
Dr. John Alexander mobilizes the epigastric artery in a live porcine lab using the Model DD1. Dr. Alexander first dissects along the outer surface of the artery with the DD1. Importantly, he does this blindly by simply letting the Differential Dissector tip follow the path of least resistance, which is created by the natural tissue plane along the artery. He then exposes the artery using a Bovie, revealing the undamaged artery with intact side branches. (Total time = 1:39)
Gauze Removal
A large surgical gauze (a mic pad) was accidentally left inside the abdomen of a pig during the first of two surgeries in a safety study. The gauze was discovered 2 weeks later when the incision was reopened. The mic pad was extensively bound to the small bowel, blocking further progress. The surgeon, Dr. John Alexander, first tried conventional forceps and scissors dissection but made little progress. He switched to the DD1, and this video demonstrates rapid, safe separation of the gauze from the small bowel without traumatizing the bowel. (Total time = 1:54)
TAR Hernia Repair – Component Separation
This is a demonstration by Dr. Chan Park who used the DD1 to blindly develop the intermuscular plane for a TAR hernia repair (live porcine lab). A 1.5 cm incision was made and the DD1 tip was introduced into the correct plane. The plane was then developed by following the path of least resistance. A laparoscopic camera was then introduced into the incision, revealing a bloodless plane. The Differential Dissector was then introduced through a second 1.5 cm incision, and it is viewed by the camera as it further dissects the plane with special attention to how it resists damage to even small (~1 mm diameter) blood vessels. The small vessel remained intact despite aggressive use of the Differential Dissector and only ruptured when stretched to breaking. Note that the tip was oscillating on high speed at all times in the video; however, at times it appears stationary due to “aliasing” with the video frame rate. (Total time = 1:23)
