학술논문

Laparoscopic lens fogging: solving a common surgical problem in standard and robotic laparoscopes via a scientific model.
Document Type
Journal Article
Source
Surgical Endoscopy & Other Interventional Techniques. Mar2018, Vol. 32 Issue 3, p1600-1606. 7p. 1 Color Photograph, 1 Diagram, 1 Chart, 1 Graph.
Subject
*SURGICAL robots
*LAPAROSCOPIC surgery
*PERITONEUM
*CHLORHEXIDINE
*POVIDONE-iodine
*THERAPEUTICS
Language
ISSN
1866-6817
Abstract
Background: Laparoscopic lens fogging (LLF) hampers vision and impedes operative efficiency. Attempts to reduce LLF have led to the development of various anti-fogging fluids and warming devices. Limited literature exists directly comparing these techniques. We constructed a model peritoneum to simulate LLF and to compare the efficacy of various anti-fogging techniques.Materials and Methods: Intraperitoneal space was simulated using a suction bag suspended within an 8 L container of water. LLF was induced by varying the temperature and humidity within the model peritoneum. Various anti-fogging techniques were assessed including scope warmers, FREDTM, ResoclearTM, chlorhexidine, betadine and immersion in heated saline. These products were trialled with and without the use of a disposable scope warmer. Vision scores were evaluated by the same investigator for all tests and rated according to a predetermined scale. Fogging was assessed for each product or technique 30 times and a mean vision rating was recorded.Results: All products tested imparted some benefit, but FREDTM performed better than all other techniques. Betadine and ResoclearTM performed no better than the use of a scope warmer alone. Immersion in saline prior to insertion resulted in decreased vision ratings. The robotic scope did not result in LLF within the model.Conclusions: In standard laparoscopes, the most superior preventative measure was FREDTM utilised on a pre-warmed scope. Despite improvements in LLF with other products FREDTM was better than all other techniques. The robotic laparoscope performed superiorly regarding LLF compared to standard laparoscope. [ABSTRACT FROM AUTHOR]

Online Access