According to Dr. Borao, when he first tried LapFinger® he was skeptical whether the device would provide added function and value beyond the instruments he had already been using. But the more he used LapFinger, the more dependent upon it he became for certain procedures. He now uses the device for the majority of his foregut surgeries.

"I now have LapFinger in my tray so it's there whenever I need it,"said Dr. Borao. "When using conventional instrumentation, you have some haptic feedback but no actual tactile sensation as you would with your finger. With the LapFinger, you can actually feel the tissue resistance and articulate the instrument all different directions to facilitate dissection in difficult to access areas. It's very easy to use and a good addition to a surgeon's armamentarium."

"With the LapFinger, you can actually feel the tissue resistance and articulate the instrument all different directions to facilitate dissection in difficult to access areas. It's very easy to use and a good addition to a surgeon's armamentarium."

As of January 2012, Dr. Borao had performed 110 cases with LapFinger, including hiatal and paraesophageal hernia repairs, gastrectomies, esophagectomies and solid organ surgery. Below are some examples of where LapFinger has provided Dr. Borao with added functionality and safety compared with conventional instrumentation.

Splenic Procedures
Dr. Borao notes that during splenic dissections, the stomach can be tightly adhered to the spleen. When the surgeon tries to mobilize the spleen, he/she can cause inadvertent injury, such as tearing the capsule or avulsing a vessel. "The key is to perform as meticulous a dissection as possible to avoid any sort of injury or bleeding,"said Dr. Borao. "The LapFinger can give you excellent exposure and enable you to dissect posteriorly in a very efficient manner."

Esophageal Procedures
When a surgeon performs dissection around the esophagus, he/she typically places a Penrose drain behind it, which requires retro-esophageal dissection. "When you go behind the esophagus, you always have the potential concern for causing injury, such as tearing,"said Dr. Borao. "With LapFinger, you simply articulate the device once you get behind the esophagus and it will encircle it, allowing for the safe placement of the Penrose."

Bariatric Surgery
Dr. Borao uses LapFinger in sleeve gastrectomy, a bariatric procedure during which the surgeon tubularizes the stomach along the lesser curvature. He notes that one of the most difficult aspects of the procedure is freeing the top of the fundus off of the spleen and diaphragmatic attachments. According to Dr. Borao, LapFinger facilitates the uplifting of those tissues and accessing of the plane so the surgeon can mobilize the posterior fundus of the stomach.