Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
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
Web of Science
PubMed
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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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- Abstract:
- 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
- Endoscopy
- Minimally invasive surgery
- Pressure control
- Smoke evacuation