Quantitative assessment of the troCarWash™ system for automated laparoscopic camera cleaning.

Autor: Ahmed M; Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA., Gowda A; BioTex, Houston, TX, USA., Alavi Naini F; Baylor College of Medicine, Houston, TX, USA., Le A; Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA., Treffalls J; Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA., Torres R; Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA., Burt BM; Baylor College of Medicine, Houston, TX, USA. bburt@mednet.ucla.edu.; Division of Thoracic Surgery, David Geffen School of Medicine, University of California, 10833 Le Conte Ave., Room 64-128, Los Angeles, CA, 90095-7276, USA. bburt@mednet.ucla.edu.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Jun; Vol. 38 (6), pp. 3470-3477. Date of Electronic Publication: 2024 May 20.
DOI: 10.1007/s00464-024-10858-z
Abstrakt: Background: Soilage of the surgical endoscope occurs frequently during minimally invasive surgery. The resultant impairment of visualization of the surgical field compromises patient safety, prolongs operative times, and frustrates surgeons. The standard practice for cleaning the surgical camera involves a disruption in the conduct of surgery by completely removing the endoscope from the field, manually cleaning its lens, treating it with a surfactant, and reinserting it into the patient; after which the surgeon resumes the procedure.
Methods: We developed an automated solution for in vivo endoscope cleaning in minimally invasive surgery- a port that detects the position of the endoscope in its distal lumen, and precisely and automatically delivers a pressurized mist of cleaning solution to the lens of the camera. No additions to the scope and minimal user interaction with the port are required. We tested the efficacy of this troCarWash™ device in a porcine model of laparoscopy. Four board-certified general surgeons were instructed to soil and then clean the laparoscope using the device. Representative pre- and post-clean images were exported from the surgical video and clarity was graded (1) digitally by a canny edge detection algorithm, and (2) subjectively by 3 blinded, unbiased observers using a semi-quantitative scale.
Results: We observed statistically significant improvements in clarity by each method and for each surgeon, and we noted significant correlation between digital and subjective scores.
Conclusion: Based on these data, we conclude that the troCarWash™ effectively restored impaired visualization in a large animal model of laparoscopy.
(© 2024. The Author(s).)
Databáze: MEDLINE
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