Abstract
Background
Ultravision™ is a new device that utilizes electrostatic precipitation to clear surgical smoke. The aim was to evaluate its performance during laparoscopic cholecystectomy.
Methods
Patients undergoing laparoscopic cholecystectomy were randomized into “active (device on)” or “control (device off).” Three operating surgeons scored the percentage effective visibility and three reviewers scored the percentage of the procedure where smoke was present. All assessors also used a 5-point scale (1 = imperceptible/excellent and 5 = very annoying/bad) to rate visual impairment. Secondary outcomes were the number of smoke-related pauses, camera cleaning, and pneumoperitoneum reductions. Mean results are presented with 95 % confidence intervals (CI).
Results
In 30 patients (active 13, control 17), the effective visibility was 89.2 % (83.3–95.0) for active cases and 71.2 % (65.7–76.7) for controls. The proportion of the procedure where smoke was present was 41.1 % (33.8–48.3) for active cases and 61.5 % (49.0–74.1) for controls. Operating surgeons rated the visual impairment as 2.2 (1.7–2.6) for active cases and 3.2 (2.8–3.5) for controls. Reviewers rated the visual impairment as 2.3 (2.0–2.5) for active cases and 3.2 (2.8–3.7) for controls. In the active group, 23 % of procedures were paused to allow smoke clearance compared to 94 % of control cases. Camera cleaning was not needed in 85 % of active procedures and 35 % of controls. The pneumoperitoneum was reduced in 0 % of active cases and 88 % of controls.
Conclusions
Ultravision™ improves visibility during laparoscopic surgery and reduces delays in surgery for smoke clearance and camera cleaning.
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Acknowledgments
James Ansell is supported by a Royal College of Surgeons Research Fellowship. Asalus Medical Instruments Ltd. provided the medical equipment required to conduct the trial.
Disclosures
Neil Warren is the inventor of the Ultravision™ instrument but has received no funds for this trial. Pete Wall and Kim Cocks have received consulting fees from Asalus Medical Instruments Ltd. Jared Torkington is a consultant to Asalus Medical Instruments Ltd. James Ansell, Stuart Goddard, David Scott-Coombes, Richard Whiston, and Michael Stechman have no conflicts of interest or financial ties to disclose.
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Ansell, J., Warren, N., Wall, P. et al. Electrostatic precipitation is a novel way of maintaining visual field clarity during laparoscopic surgery: a prospective double-blind randomized controlled pilot study. Surg Endosc 28, 2057–2065 (2014). https://doi.org/10.1007/s00464-014-3427-8
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DOI: https://doi.org/10.1007/s00464-014-3427-8