A novel system identifies ureters during abdominal surgery by electrically stimulating and monitoring smooth muscle excitability.

The Allotrope Medical (Houston, TX, USA) StimSite is an intuitive, easy to use device that provides surgeons operating in the lower abdomen and pelvis with the ability to elicit visible movement on demand by electrical stimulation at any point along the length of the ureter, eliciting a clearly visible vermiculation contraction that is evident even when hidden behind other soft tissues, including scar tissue. This allows for immediate identification and localization so that the surgeon can proceed with the operation safely.

StimSite also allows the surgeon to switch between electrocautery signals from standard electrosurgical generators and smooth muscle stimulation, without the need to exchange instruments beforehand. The seamless workflow integration is achieved by connecting the StimSite signal box to existing laparoscopic bipolar instruments, electrosurgical generators, and robotic surgical platforms, such as the Intuitive Surgical (Sunnyvale, CA, USA) DaVinci system.

“With ureter injuries being top of mind for all surgeons operating in the pelvis, we are excited to be able to offer a technology that helps surgeons identify this important structure in a simple and elegant way,” said Albert Huang, MD, CEO of Allotrope Medical and the inventor of StimSite. “StimSite gives surgeons a new capability to their existing instruments; helping them to provide the best surgical experience for physician and patient alike.”

“Whether it is a gynecologic or colorectal operation, a significant portion of operating room time is spent looking for the ureter and keeping it safe,” said Brian Dunkin, MD, past president of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). “StimSite provides surgeons with an elegant tool to help rapidly identify the ureter, keep it safe from harm, and promote the progression of a pelvic operation. It should be in the toolbox of every surgeon doing pelvic surgery.”

Ureter identification is required in a multitude of common surgical procedures such as hysterectomies, endometriosis ablations, and colon resections. Injury to ureters can have a significant impact on the patient's hospitalization and overall quality of life.

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