Efficacy of Using a Novel Endoscopic Lens Cleaning Device: A Prospective Randomized Controlled Trial

Cassera, Maria A.; Goers, Trudie A.; Spaun, Georg; Swanström, Lee L.

doi:10.1177/1553350611399297

Cited by 22 publications

(29 citation statements)

References 9 publications

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“…10 Efforts to maintain continuous endoscopic visualization have been primarily directed toward cleansing of the lens using irrigation systems. 1,4,6,11,12 In this study, we introduce the NAG, which is an anatomically shaped, stretchable, watertight stent that is placed in the bilateral nares. It provides a conical funnel to protect the external nares and a working corridor to the posterior nasal cavity.…”

Section: Discussionmentioning

confidence: 99%

“…With the advent of endoscopic endonasal approaches (EEAs) to the skull base, devices have emerged to assist with maintaining adequate endoscopic visualization. Soiling of the endoscope lens may disrupt the flow of the operation 1 and may result in technical errors or misjudgment, potentially causing patient injury. 2,3 In addition, disturbances may lengthen the procedure time and may increase treatment costs, essentially decreasing surgical efficiency.…”

Section: Introductionmentioning

confidence: 99%

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Utility of Nasal Access Guides in Endoscopic Endonasal Skull Base Surgery: Assessment of Use during Cadaveric Dissection and Workflow Analysis in Surgery

Velasquez

Ahmed

Lavigne

et al. 2020

J Neurol Surg B Skull Base

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Background A nasal access guide (NAG) for endoscopic endonasal approaches (EEAs) to the skull-base has been developed and approved for clinical use but its utility has not been formally investigated. Objectives The study aims to assess the effect of a NAG on endoscopic visualization during cadaveric dissection and to perform a workflow analysis with process-based performance measures in the operating room and their effect on clinical outcomes. Methods Skull-base course participants were observed during hands-on cadaveric dissection with and without NAG. Instances of endoscope withdrawal for lens cleaning and inadequate visualization due to lens soiling were tabulated. Participants completed a Likert-scale survey examining the NAG utility and provided an overall grading. Surgical workflow and process-based performance on patients undergoing EEA to the skull-base was analyzed. Passage of powered and dissecting instruments, removal of endoscopes for cleaning, and dislodgment or migration of the device were reviewed. Postoperative assessments included mucosal trauma and synechiae formation. Results Instances of endoscope soiling and manual cleaning were significantly reduced by 40% and 61% with the NAG during cadaveric dissection. The overall grading of the device was 2.75/3. Surgical workflow was observed in 35 patients. Average number of passes of endoscopes, instruments, and powered tools during a 10-minute observation period were 3,17, and 5 during the surgical approach, and 3, 18, and 1 during tumor dissection. Dislodgement of the device occurred in 25.7% and migration of the device in 2.8% of cases. Postoperative synechiae, exposed cartilage or septal perforation was not observed in follow up. Conclusion NAG can significantly reduce inadequate visualization during EEA to the skull-base and has the potential to reduce instances of nasal trauma. Participants assessed its overall utility as being “excellent.”

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Utility of Nasal Access Guides in Endoscopic Endonasal Skull Base Surgery: Assessment of Use during Cadaveric Dissection and Workflow Analysis in Surgery

Velasquez

Ahmed

Lavigne

et al. 2020

J Neurol Surg B Skull Base

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“…Laparoscopic surgery is more physically and psychologically di cult for surgeons than open surgery; one explanation for this di culty is that the surgical eld of view is dependent on the scope operator [1,2]. Clear visualization of the surgical eld is critical during laparoscopic surgery [1,3,4]. When laparoscopic lens contamination occurs, the standard procedure is to remove the laparoscope from the abdominal cavity, wipe it with dry gauze, and then apply anti-fog solution or wash it with hot water [3].…”

Section: Introductionmentioning

confidence: 99%

“…Clear visualization of the surgical eld is critical during laparoscopic surgery [1,3,4]. When laparoscopic lens contamination occurs, the standard procedure is to remove the laparoscope from the abdominal cavity, wipe it with dry gauze, and then apply anti-fog solution or wash it with hot water [3]. This process disrupts the surgical work ow, prolongs operation time, and increases the risk of harm to the patient [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Reduction in the Frequency of Scope Contamination During Laparoscopic Surgery Correlates with Scope Operator Experience

Ito

Minamimura

Tanaka

et al. 2020

Preprint

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Background As laparoscopic colorectal cancer surgery becomes more common in mid-sized municipal hospitals in Japan, young trainees have increasing opportunities to attend laparoscopic colorectomy procedures as a scope operator. However, the performance of the inexperienced scope operator may affect the operative outcome. This study aims to provide a quantitative measure of the scope operator’s performance, by analyzing scope contamination events, and to determine the influence of this measure on surgical outcomes.Methods We retrospectively analyzed the operative videos of 70 sigmoid colectomy or high anterior resection cases performed between February 2014 and July 2019 in our hospital. Twenty-four young surgeons alternated assisting with the procedure as the scope operator. To quantify the scope operators’ performance, the frequency of laparoscopic lens contamination events (FLC) during surgery was determined. The FLC and operative outcomes were compared among the first, second, and subsequent procedures performed by each scope operator. We identified the cause of lens contamination and surgical situation in which contamination occurred. We examined the relationship between the FLC and experience level of the scope operator for specific types of contamination and surgical situations.Results A total of 733 lens contaminations were observed. The median FLC was 10 (minimum: 1, maximum: 34) during each operation. The FLC and number of procedures performed by the scope operator had a negative linear correlation. Multivariate analysis showed that the experience level of the scope operator was the only independent predictor of operation time. There was also a negative linear correlation between the number of procedures performed by the scope operator and scope contamination during colorectal mobilization.Conclusions Scope operator experience decreases scope contamination and could facilitate the laparoscopic surgical workflow. The influence of the scope operator’s performance should be emphasized.

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“…Not only does lens contamination influence the surgical view, it also affects the surgeon’s mood. Methods for prevention of lens condensation have been well described in previous publications [ 1 – 3 ], whereas little has been written about methods to prevent lens contamination from the port [ 4 ]. We have developed a new camera port cleaner and compared the effectiveness of the device to that of previously reported instruments.…”

mentioning

confidence: 99%

A novel device for cleaning the camera port during laparoscopic surgery

et al. 2015

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AimPoor visualization of the operative field due to an obscured camera lens is a problem frequently encountered while performing laparoscopic surgery. Little has been published about the prevention of lens obstruction specifically due to a contaminated camera port used for laparoscopic surgery. The aim of our study is to develop a new device, the Endowiper, for cleaning the laparoscopic port.MaterialsThe new cleaner for the port’s valve is made from rolled gauze. To simulate a surgical environment in the laboratory, we have used pseudo-blood to smudge the port’s valve.MethodIn order to demonstrate the efficacy and safety of the Endowiper, we compared our method using this device with three previously reported port cleaning methods. These methods included use of gauze tightly wrapped around an endoscopic dissecting cramp, a small piece of gauze grasped by an endoscopic dissecting cramp, and a swab. We repeated the performance tests 280 times, 240 using a 12-mm trocar port and 40 with a 5-mm port.ResultsWith the 12-mm port, the complete port clearance rate achieved was 83.3 % by Endowiper, 56.7 % by wrapped gauze, 36.7 % by small gauze, and 40.0 % by swab. Trouble rate encountered during the procedure was 0 % by Endowiper, 1.7 % by wrapped gauze, 15 % by small gauze, and 90 % by swab. For the 5-mm port, the complete port clearance rate was 85 % by Endowiper and 20 % by sterile swab. The trouble rate was 0 % by Endowiper and 30 % by swab. Endowiper had a significantly superior result related to clearance rate than the other three methods in both the 12- (p < 0.001) and 5-mm (p < 0.001) ports. For trouble rate, Endowiper had a significantly superior result in both the 12- (p < 0.001) and 5-mm (p < 0.01) ports.ConclusionThis Endowiper will be an inexpensive device with a benefit to laparoscopic surgeons.

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Efficacy of Using a Novel Endoscopic Lens Cleaning Device: A Prospective Randomized Controlled Trial

Abstract: An intra-abdominal laparoscopic cleaning device can effectively clean the laparoscopic lens and lead to less workflow interruption. Although not documented in this study, it may also lead to shorter operative times.

Cited by 22 publications

References 9 publications

Utility of Nasal Access Guides in Endoscopic Endonasal Skull Base Surgery: Assessment of Use during Cadaveric Dissection and Workflow Analysis in Surgery

Utility of Nasal Access Guides in Endoscopic Endonasal Skull Base Surgery: Assessment of Use during Cadaveric Dissection and Workflow Analysis in Surgery

Reduction in the Frequency of Scope Contamination During Laparoscopic Surgery Correlates with Scope Operator Experience

A novel device for cleaning the camera port during laparoscopic surgery

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