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Surgical smoke management for minimally invasive (micro)endoscopy: an experimental study.
- Source :
-
Surgical Endoscopy & Other Interventional Techniques . Oct2010, Vol. 24 Issue 10, p2492-2501. 10p. 4 Color Photographs, 3 Graphs. - Publication Year :
- 2010
-
Abstract
- Background: The aim of this study was to investigate the use of surgical smoke-producing procedures such as laser ablation or electrosurgery in minimally invasive microendoscopic procedures. This study proposes a technical solution to efficiently remove surgical smoke from very small endoscopic cavities using microports as small as 20 G (0.9 mm) in diameter. Methods: The experimental laboratory study used small, rigid, transparent plastic cavity models connected with tubes and pressure sensors to establish an endoscopic in vitro laboratory model. A Kalium-Titanyl-Phosphate (KTP) laser with a 0.5-mm fiber optic probe was used to produce smoke from bovine scleral tissue in the cavity. Endoscopic gas insufflation into the model was generated by pressurized air and a microvalve. A laboratory vacuum pump provided smoke and gas suction via a microvalve. A self-built control and steering system was utilized to control intracavital pressure during experimental insufflation and suction. Results: Problems related to smoke-generating processes, such as laser vaporization or electrocautery, in small closed cavities were first analyzed. A theoretical and mechatronic laboratory model was established and tested. Intracavital pressure and gas flow were measured first without and then with smoke generation. A new construction design for the suction tube was proposed due to rapid obstruction by smoke particles. Conclusions: Surgical smoke evacuation from endoscopic cavities that are as small as 2 cm in diameter via minimally invasive ports as small as 20 G (0.9 mm) in diameter may be safe and efficient if sufficient gas exchange is provided during smoke generation by laser or electrosurgical instruments. However, maintaining a low and constant pressure in the cavity during gas exchange and adopting a special construction design for the suction tube are essential to provide an excellent view during the surgical maneuver and to minimize potential toxic side effects of the smoke. [ABSTRACT FROM AUTHOR]
- Subjects :
- *SURGICAL smoke
*LASER endoscopy
*ELECTROSURGERY
*GAS flow
*MEDICAL suction
Subjects
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 24
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 53913150
- Full Text :
- https://doi.org/10.1007/s00464-010-0991-4