Dynamic near-infrared carbon dioxide leak visualization detection during surgery using the FLIR GF343 optical imaging system

Excerpt

There is ongoing concern regarding the aerosolization hazard of laparoscopy since the outbreak of the COVID-19 pandemic [1‐4]. As a global crisis without precedent in the modern surgical era, expert opinion and theoretical extrapolations dominated initial considerations and directions regarding operative care processes. As elective surgical care restarts again, it’s imperative that we advance in a systemic, scientific way to fortify minimally invasive surgical practice against further waves of this or other airborne pathogens and pollutants [5]. The fundamental driver of any higher risk of intraabdominal pathogen aerosolization by laparoscopy versus laparotomy is the use and leakage of surgical gas, specifically carbon dioxide (CO₂) [6]. We set out to develop a reliable model to determine intraoperative unfiltered CO₂ leak into the operating room from out of the patient to enable comprehensive understanding and address of this substantial issue. A practical and clinically deployable methodology for leak ascertainment would allow immediate feedback for surgeons intraoperatively regarding factors within their control (e.g., leaks related to skin incision or instrument usage including leaky port seals and uncapped irrigation channels) that otherwise often go unnoticed. It also would allow surgeons share best practice with evidential support and provide reassurance to centers who do not have a significant problem with CO₂ leaks. Finally, it would enable rapid testing and iterative development of the many potential adjunctive mechanical solutions (e.g., improved trocar seals and valves, gas leak traps, etc.) including reproducibility in assessment and trialing. …