9. Under gentle pressure and assuring complete visualization, the trigger may be squeezed advancing the blade and incising the peritional lining. At this point the user should apply minimal pressure to avoid an uncontrolled entry into the retroperitenium. Visiport™ PLUS with fixation Step by Step Guide 10. The Visiport™ PLUS obturator should be removed, leaving the Versaport™ PLUS housing and fixation cannula in position. You are now prepared to insufflate the abdomen. Numerous options exist for access to the peritoneal cavity and creation of pneumoperitoneum. Literature suggests that each of these techniques are safe when utilized by properly trained surgeons. www.covidien.com/autosuture For more information or to set up a product demonstration contact your local Covidien surgical devices specialist or call customer service at 1-800-722-8772 150 Glover Avenue Norwalk, CT 06856 COVIDIEN, COVIDIEN with logo and ™ marked brands are trademarks of Covidien AG and its affiliate. © 2008 Covidien AG or its affiliate. All rights reserved. 22277 HW 23M 01.08 CBK00050M Great Performance Starts Here Visiport™ PLUS Optical Trocars Step by Step Guide This brochure is intended to provide a description of the application of the Visiport™ PLUS optical trocar. Always refer to the instructions for use included with the product for complete indications, contraindications, warnings, and precautions. Insufflation of the abdomen prior to the insertion of the Visiport™ PLUS is at the discretion of the surgeon as determined by the conditions of each case. The potential for abdominal adhesions or anatomical anomalies should be considered before using this device without first establishing pneumoperitoneum. 1. Once assembled, the Visiport™ PLUS may be white balanced. The camera should be focused and white balanced against gauze, with care taken to focus on the gauze and not the clear plastic dome. This assures a clear, crisp image with proper colors. 5. Deployment should be slow and methodical, and the position of the Visiport™ PLUS must be closely monitored as it divides the tissue layers. 2. Once the access site has been chosen, an incision should be made in the skin. 6. The trocar should now be against the midline fascia. The trigger should be squeezed while gentle pressure and twisting motions are applied. The incision should be made as large as the outer diameter of the assembled Visiport™ PLUS. 3-Way Stopcock Blunt Clear DOME Versaport™ Plus Fixation cannula TRIGGER 3. Uniform and direct pressure should be applied. Deployment can be achieved using a combination of gentle pressure and twisting, with occasional firing of the blade. The blade should only be fired when the surgeon is certain of the position of the Visiport™ PLUS in the abdominal wall. 7. When the fascia is completely incised, the trocar enters the preperitoneal space, and is against the peritoneal lining. The abdominal viscera may be seen through the peritoneal lining. 4. The blade is deployed (and immediately retracted) when the trigger is pulled. The Visiport™ PLUS may be rotated as it divides the tissue layers. 8. Before penetrating the peritoneal lining, it may be helpful to adjust the angle of approach of the Visiport™ PLUS to avoid contacting retroperitoneal structures upon penetration.