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08.08.2017 | New Technology

Laparoscopic lens fogging: solving a common surgical problem in standard and robotic laparoscopes via a scientific model

verfasst von: Todd G. Manning, Nathan Papa, Marlon Perera, Shannon McGrath, Daniel Christidis, Munad Khan, Richard O’Beirne, Nicholas Campbell, Damien Bolton, Nathan Lawrentschuk

Erschienen in: Surgical Endoscopy | Ausgabe 3/2018

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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.
Literatur
1.
Zurück zum Zitat Dubois F, Icard P, Berthelot G, Levard H (1990) Coelioscopic cholecystectomy: preliminary report of 36 cases. Lippincott Williams & Wilkins, WK Health, Philadelphia Dubois F, Icard P, Berthelot G, Levard H (1990) Coelioscopic cholecystectomy: preliminary report of 36 cases. Lippincott Williams & Wilkins, WK Health, Philadelphia
2.
Zurück zum Zitat Perissat J, Collet D, Belliard R, Dost C, Bikandou G (1990) Cholelithiasis. Laparoscopic treatment with intracorporeal lithotripsy followed by cholecystostomy or cholecystectomy. Personal technique. Chirurgie; Mémoires De L’académie De Chirurgie 116(3):243–247PubMed Perissat J, Collet D, Belliard R, Dost C, Bikandou G (1990) Cholelithiasis. Laparoscopic treatment with intracorporeal lithotripsy followed by cholecystostomy or cholecystectomy. Personal technique. Chirurgie; Mémoires De L’académie De Chirurgie 116(3):243–247PubMed
4.
Zurück zum Zitat Kitano S, Tomikawa M, Iso Y, Iwata S, Gondo K, Moriyama M, Sugimachi K (1992) A safe and simple method to maintain a clear field of vision during laparoscopic cholecystectomy. Surg Endosc 6(4):197–198CrossRefPubMed Kitano S, Tomikawa M, Iso Y, Iwata S, Gondo K, Moriyama M, Sugimachi K (1992) A safe and simple method to maintain a clear field of vision during laparoscopic cholecystectomy. Surg Endosc 6(4):197–198CrossRefPubMed
5.
Zurück zum Zitat Lawrentschuk N, Fleshner NE, Bolton DM (2010) Laparoscopic lens fogging: a review of etiology and methods to maintain a clear visual field. J Endourol 6:905CrossRef Lawrentschuk N, Fleshner NE, Bolton DM (2010) Laparoscopic lens fogging: a review of etiology and methods to maintain a clear visual field. J Endourol 6:905CrossRef
6.
Zurück zum Zitat Manning TG, Perera M, Christidis D, Kinnear N, McGrath S, O’Beirne R, Zotov P, Bolton D, Lawrentschuk N (2017) Visual occlusion during minimally invasive surgery: a contemporary review of methods to reduce laparoscopic and robotic lens fogging and other sources of optical loss. J Endourol. 31(4):327–333CrossRefPubMed Manning TG, Perera M, Christidis D, Kinnear N, McGrath S, O’Beirne R, Zotov P, Bolton D, Lawrentschuk N (2017) Visual occlusion during minimally invasive surgery: a contemporary review of methods to reduce laparoscopic and robotic lens fogging and other sources of optical loss. J Endourol. 31(4):327–333CrossRefPubMed
7.
Zurück zum Zitat Van Deurzen DFP, Mannaerts GHH, Jakimowicz JJ, Cuschieri A (2005) Prevention of lens condensation in laparoscopic surgery by lens heating with a thermos flask. Surg Endosc 19(2):299–300CrossRefPubMed Van Deurzen DFP, Mannaerts GHH, Jakimowicz JJ, Cuschieri A (2005) Prevention of lens condensation in laparoscopic surgery by lens heating with a thermos flask. Surg Endosc 19(2):299–300CrossRefPubMed
8.
Zurück zum Zitat Schurr MO, Kunert W, Arezzo A, Buess G (1999) The role and future of endoscopic imaging systems. Endoscopy 31(7):557–562CrossRefPubMed Schurr MO, Kunert W, Arezzo A, Buess G (1999) The role and future of endoscopic imaging systems. Endoscopy 31(7):557–562CrossRefPubMed
9.
Zurück zum Zitat McCain LA, Jones G (1995) Endoscopic techniques in aesthetic plastic surgery the hopkins rod lens system. Plast Surg Nurs 15(3):145–178CrossRefPubMed McCain LA, Jones G (1995) Endoscopic techniques in aesthetic plastic surgery the hopkins rod lens system. Plast Surg Nurs 15(3):145–178CrossRefPubMed
11.
Zurück zum Zitat Drysch A, Schmitt K, Uribe B, Yoon R, Okhunov Z, Landman J (2016) Comparative analysis of techniques to prevent laparoscopic fogging. Minim Invasive Ther Allied Technol 25:1–4CrossRef Drysch A, Schmitt K, Uribe B, Yoon R, Okhunov Z, Landman J (2016) Comparative analysis of techniques to prevent laparoscopic fogging. Minim Invasive Ther Allied Technol 25:1–4CrossRef
13.
Zurück zum Zitat Farley DR, Greenlee SM, Larson DR, Harrington JR (2004) Double-blind, prospective, randomized study of warmed, humidified carbon dioxide insufflation vs standard carbon dioxide for patients undergoing laparoscopic cholecystectomy. Arch Surg 139(7):739–743CrossRefPubMed Farley DR, Greenlee SM, Larson DR, Harrington JR (2004) Double-blind, prospective, randomized study of warmed, humidified carbon dioxide insufflation vs standard carbon dioxide for patients undergoing laparoscopic cholecystectomy. Arch Surg 139(7):739–743CrossRefPubMed
14.
Zurück zum Zitat Lawrentschuk N, Bolton DM (2009) Re: use of a warming bath to prevent lens fogging during laparoscopy. (From Brown JA, Inocencio MD, and Sundaram CP. J Endourol 2008; 22: 2413). J Endourol 23(7):1213. doi:10.1089/end.2009.0122 CrossRefPubMed Lawrentschuk N, Bolton DM (2009) Re: use of a warming bath to prevent lens fogging during laparoscopy. (From Brown JA, Inocencio MD, and Sundaram CP. J Endourol 2008; 22: 2413). J Endourol 23(7):1213. doi:10.​1089/​end.​2009.​0122 CrossRefPubMed
15.
Zurück zum Zitat den Boer KT, Herder JL, Sjoerdsma W, Meijer DW, Gouma DJ, Stassen HG (1999) Sensitivity of laparoscopic dissectors. What can you feel? Surg Endosc 13(9):869–873CrossRef den Boer KT, Herder JL, Sjoerdsma W, Meijer DW, Gouma DJ, Stassen HG (1999) Sensitivity of laparoscopic dissectors. What can you feel? Surg Endosc 13(9):869–873CrossRef
16.
Zurück zum Zitat Flemming E, Bessell JR, Kunert W, Eibl H, Buess G (1996) Principles determining optical clarity in endoscopic surgery. Minim Invasive Ther Allied Technol 5(5):440CrossRef Flemming E, Bessell JR, Kunert W, Eibl H, Buess G (1996) Principles determining optical clarity in endoscopic surgery. Minim Invasive Ther Allied Technol 5(5):440CrossRef
17.
Zurück zum Zitat Bessell JR, Flemming E, Kunert W, Buess G (1996) Maintenance of clear vision during laparoscopic surgery. Minim Invasive Ther Allied Technol 5(5):450CrossRef Bessell JR, Flemming E, Kunert W, Buess G (1996) Maintenance of clear vision during laparoscopic surgery. Minim Invasive Ther Allied Technol 5(5):450CrossRef
18.
Zurück zum Zitat North GR, Erukhimova TL (2009) Atmospheric thermodynamics. [electronic resource]: elementary physics and chemistry. Cambridge University Press, Cambridge North GR, Erukhimova TL (2009) Atmospheric thermodynamics. [electronic resource]: elementary physics and chemistry. Cambridge University Press, Cambridge
19.
Zurück zum Zitat Gao X, Yan X, Yao X, Xu L, Zhang K, Zhang J, Yang B, Jiang L (2007) The dry-style antifogging properties of mosquito compound eyes and artificial analogues prepared by soft lithography. Adv Mater 19(17):2213CrossRef Gao X, Yan X, Yao X, Xu L, Zhang K, Zhang J, Yang B, Jiang L (2007) The dry-style antifogging properties of mosquito compound eyes and artificial analogues prepared by soft lithography. Adv Mater 19(17):2213CrossRef
20.
Zurück zum Zitat Ohdaira T, Nagai H, Kayano S, Kazuhito H (2007) Antifogging effects of a socket-type device with the superhydrophilic, titanium dioxide-coated glass for the laparoscope. Surg Endosc 21(2):333–338CrossRefPubMed Ohdaira T, Nagai H, Kayano S, Kazuhito H (2007) Antifogging effects of a socket-type device with the superhydrophilic, titanium dioxide-coated glass for the laparoscope. Surg Endosc 21(2):333–338CrossRefPubMed
21.
Zurück zum Zitat Rosen MJ, Kunjappu JT (2012) Surfactants and interfacial phenomena, 4th edn. Ringgold Inc, Avon, pp 1–2CrossRef Rosen MJ, Kunjappu JT (2012) Surfactants and interfacial phenomena, 4th edn. Ringgold Inc, Avon, pp 1–2CrossRef
22.
Zurück zum Zitat Chevallier P, Sp Turgeon, Sarra-Bournet C, Rl Turcotte, Gt Laroche (2011) Characterization of Multilayer Anti-Fog Coatings. ACS Appl Mater Interfaces 3(3):750CrossRefPubMed Chevallier P, Sp Turgeon, Sarra-Bournet C, Rl Turcotte, Gt Laroche (2011) Characterization of Multilayer Anti-Fog Coatings. ACS Appl Mater Interfaces 3(3):750CrossRefPubMed
23.
Zurück zum Zitat Rosen MJ, Kunjappu JT (2012) Surfactants and interfacial phenomena, 4th edn. Ringgold Inc, Avon, pp 214–215CrossRef Rosen MJ, Kunjappu JT (2012) Surfactants and interfacial phenomena, 4th edn. Ringgold Inc, Avon, pp 214–215CrossRef
25.
Zurück zum Zitat Wong CG, Gu X, Barkoukis M (2013) Novel laparoscope defogging and cleaning device for robot-assisted laparoscopic prostatectomy (RALP). J Endourol 27(1):144 Wong CG, Gu X, Barkoukis M (2013) Novel laparoscope defogging and cleaning device for robot-assisted laparoscopic prostatectomy (RALP). J Endourol 27(1):144
27.
Zurück zum Zitat Nezhat C, Morozov V (2008) A simple solution to lens fogging during robotic and laparoscopic surgery. J Soc Laparoendosc Surg 12(4):431 Nezhat C, Morozov V (2008) A simple solution to lens fogging during robotic and laparoscopic surgery. J Soc Laparoendosc Surg 12(4):431
28.
Zurück zum Zitat Khan MJ, Karim O (2013) Use of Ethicon Vicryl foil and robotic camera lights to warm the robotic scope lens to prevent lens fogging, 2nd edn. Wiley, Hoboken Khan MJ, Karim O (2013) Use of Ethicon Vicryl foil and robotic camera lights to warm the robotic scope lens to prevent lens fogging, 2nd edn. Wiley, Hoboken
30.
Zurück zum Zitat Piromchai P, Kasemsiri P, Thanaviratananich S (2011) Alternative agents to prevent fogging in head and neck endoscopy. Clin Med Insights 4:1 Piromchai P, Kasemsiri P, Thanaviratananich S (2011) Alternative agents to prevent fogging in head and neck endoscopy. Clin Med Insights 4:1
32.
Zurück zum Zitat Yavuz Y, Skogås JG, Güllüoglu MG, Langø T, Mårvik R (2006) Are cold light sources really cold? Surg Laparosc Endoscand Percutaneous Tech 16(5):370–376CrossRef Yavuz Y, Skogås JG, Güllüoglu MG, Langø T, Mårvik R (2006) Are cold light sources really cold? Surg Laparosc Endoscand Percutaneous Tech 16(5):370–376CrossRef
Metadaten
Titel
Laparoscopic lens fogging: solving a common surgical problem in standard and robotic laparoscopes via a scientific model
verfasst von
Todd G. Manning
Nathan Papa
Marlon Perera
Shannon McGrath
Daniel Christidis
Munad Khan
Richard O’Beirne
Nicholas Campbell
Damien Bolton
Nathan Lawrentschuk
Publikationsdatum
08.08.2017
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 3/2018
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5772-x

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