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Title: Laparoscopic lens fogging: solving a common surgical problem in standard and robotic laparoscopes via a scientific model
Austin Authors: Manning, Todd G ;Papa, Nathan;Perera, Marlon ;McGrath, Shannon ;Christidis, Daniel;Khan, Munad;O'Beirne, Richard;Campbell, Nicholas;Bolton, Damien M ;Lawrentschuk, Nathan
Affiliation: Young Urology Researchers Organisation (YURO), Melbourne, Australia
Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Department of Engineering (Chemical), University of Melbourne, Melbourne, Australia
Issue Date: Mar-2018 2017-08-08
Publication information: Surgical endoscopy 2018; 32(3): 1600-1606
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.
DOI: 10.1007/s00464-017-5772-x
ORCID: 0000-0001-8553-5618
Journal: Surgical endoscopy
PubMed URL: 28791559
Type: Journal Article
Subjects: Fogging
Laparoscopic equipment
Laparoscopic lens fogging
Laparoscopic surgery
Robotic surgery
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