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Mattes, D; Silajdzic, E; Mayer, M; Horn, M; Scheidbach, D; Wackernagel, W; Langmann, G; Wedrich, A.
Surgical smoke management for minimally invasive (micro)endoscopy: an experimental study.
Surg Endosc. 2010; 24(10):2492-2501 Doi: 10.1007/s00464-010-0991-4
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Führende Autor*innen der Med Uni Graz
Mattes Dietmar
Co-Autor*innen der Med Uni Graz
Horn Michael
Langmann Gerald
Mayer Monika
Wackernagel Werner
Wedrich Andreas

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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. 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. 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. 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.
Find related publications in this database (using NLM MeSH Indexing)
Animals -
Electrosurgery - adverse effects
Endoscopy - adverse effects
In Vitro Techniques -
Laser Therapy - adverse effects
Microsurgery -
Minimally Invasive Surgical Procedures -
Models, Structural -
Smoke -

Find related publications in this database (Keywords)
Surgical smoke
Minimally invasive surgery
Pressure control
Smoke evacuation
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