A new optic cleaning and visualization stabilizing system for endoscopic surgery

Schurr, M. O.; Bablich, H.; Wurster, H.; Melzer, Andreas; Roth, Kathryn; Wiest, F.M.; Bueß, G.

doi:10.1080/0961625x.1994.11665539

Cited by 10 publications

(4 citation statements)

References 1 publication

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“…Few other studies have evaluated the effect of gas insufflation techniques. In one study, Schurr, Bablich [ 41 ] found that carbon dioxide insufflation to clear endoscopic lenses from fogging and contamination was highly effective and efficient, although the outcomes were not measured against an active comparator. In another study, Farley, Greenlee [ 42 ] conducted a double-blind randomised trial to investigate the effect of standard versus warmed and humified carbon dioxide insufflation upon lens fogging in patients undergoing laparoscopic cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

Effective cleaning of endoscopic lenses to achieve visual clarity for minimally invasive abdominopelvic surgery: a systematic review

2021

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Objective To review the recently available interventions to achieve optimal visual clarity in laparoscopic abdominopelvic surgery compared to conventional cleaning alternatives. Summary background data Currently, there is no consensus on the most effective method for the cleaning of endoscopic lenses used in minimally invasive abdominopelvic surgery. Methods Literature searching for articles relevant to answering a predefined research question was performed in December 2019 and involved searching of the electronic databases of MEDLINE, the Cochrane Registry, and EMBASE. Basic search terms were derived using the PICO (population, intervention, comparator and outcomes) framework and through a scoping search of literature via MEDLINE. A manual search of Google Scholar and citation screening of eligible studies was also performed to ensure the identification and inclusion of all pertinent studies to address the research question. Results Among conventional and readily available methods, the most effective approaches involved heated sterile water, heating of laparoscope lenses, and surfactant solutions, including FRED and Ultra-Stop, while evaluations of all novel devices and methods were more effective than controls, which included lens wiping systems and air and carbon dioxide flow systems. While the former surgical techniques were consistently associated with superior lens cleaning ability and/or defogging capability and subsequent optical clarity of images within the surgical field, no methods conferred any meaningful effects upon other clinically important outcomes, such as operative time, costs, complication rates and length of stay, suggesting that decision making concerning the selection of lens cleaning method/device should suit the preferences of the instrument operator and/or the responsible surgeon. Conclusions We demonstrated that a range of endoscopic lens cleaning methods and devices can be used to achieve sufficient optical clarity of the laparoscopic surgical field through either preventing lenses from fogging and/or facilitating the inter-operative cleaning of fouled lenses. Despite the various methods evaluated in this review, there were no significant differences in complication rates between the intervention and control groups.

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Section: Discussionmentioning

confidence: 99%

Effective cleaning of endoscopic lenses to achieve visual clarity for minimally invasive abdominopelvic surgery: a systematic review

2021

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“…In laparoscopy fogging of the front lens is a frequent and disruptive phenomenon which usually requires extracorpo real optic cleaning [5]. Re-fogging after external cleaning is also well known and can lead to continuous interruption of the operation.…”

Section: Clear Visionmentioning

confidence: 99%

“…In 1993 an overtube (Figure 3) for conventional endo scopes was developed with optic rinsing and drying noz zles at the tip so that the front lens could be cleaned at all times without withdrawing the optic from the body [5]. An additional function was a smoke evacuation system that al lowed the removal of smoke resulting from HF application.…”

Section: Clear Visionmentioning

confidence: 99%

The Role and Future of Endoscopic Imaging Systems

Schurr

Kunert²,

Arezzo³

et al. 1999

Endoscopy

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Visual perception is the main sensory input from the environment in most situations of daily life. It is the only sensory input from the operating field in endoscopic surgery, and thus the qualities of the optical imaging system have a considerable impact on the course of the surgical intervention. Significant improvements have been made recently in various fields of science and engineering, influencing endoscopic imaging systems in experimental and clinical use. Among these are technologies that improve the endoscope itself in terms of providing new visual features, such as fogging prevention and plastic images, using new illumination techniques. Other developments concern the improvement of image resolution and color fidelity through new charge-coupled device (CCD) sensors or alternative techniques for image creation. Finally, the combination of endoscopic technologies with robotics provides for intuitive and more efficient direction of the line of sight.

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“…Such minimally invasive approaches have become widely used in various clinical departments, including digestive surgery, thoracic surgery, urology, and gynecology. Although laparoscopic surgery is conducted by visualization through an endoscope lens, low visibility in the images caused by protein fouling and/or fog formation on the lens surface remains a critical issue. , The lens needs to be cleaned during each operation to remove biological fluids, protein, fog, and blood, resulting in increased medical expenses, patient cost, and surgical time, along with other problems including the potential risk of blood clots and the introduction of foreign material. Therefore, there is a critical need for functional coatings with high transparency that can prevent the formation of blood clots and fog on endoscope lenses …”

Section: Introductionmentioning

confidence: 99%

Antifibrinogen, Antireflective, Antifogging Surfaces with Biocompatible Nano-Ordered Hierarchical Texture Fabricated by Layer-by-Layer Self-Assembly

et al. 2017

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Endoscopic surgery is a minimally invasive approach that is widely used in various clinical departments, including digestive surgery, thoracic surgery, and urology, because it can minimize the burden on patients. To perform more elaborate procedures, highly functional coatings that enhance the operation efficiency of the related equipment are required; for example, coatings to improve the visibility through endoscope lenses are needed. In this study, we designed multifunctional surfaces that displayed antithrombogenicity, antireflection, and antifogging by controlling nano-ordered hierarchical structures fabricated via layer-by-layer self-assembly. The coatings were composed of polyelectrolyte multilayers prepared from blends of poly(vinyl alcohol) (PVA) and poly(acrylic acid) (PAA) that were deposited in alternating layers with blends of poly(allylamine hydrochloride) (PAH), PVA, and PAA. Although mixing cationic PAH and anionic PAA solutions generally causes polyelectrolyte−polyelectrolyte complexes (PECs) to form through electrostatic interactions, we found that PAH and PAA hardly formed PECs when PVA was present in the solution containing PAA. Consequently, PAA behaved differently in cationic and anionic solutions, resulting in the formation of coatings with hierarchical texture. The structures possessed antireflective properties with a graded refractive index and >95% transmittance. The coatings also displayed resistance to protein adsorption derived from free hydroxyl groups and antifogging performance caused by hydrophilicity combined with the strong hydrogen bonding ability of PVA. The results of this study would be valuable for the development of innovative biomedical devices through a simple and environmentally friendly approach.

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A new optic cleaning and visualization stabilizing system for endoscopic surgery

Cited by 10 publications

References 1 publication

Effective cleaning of endoscopic lenses to achieve visual clarity for minimally invasive abdominopelvic surgery: a systematic review

Effective cleaning of endoscopic lenses to achieve visual clarity for minimally invasive abdominopelvic surgery: a systematic review

The Role and Future of Endoscopic Imaging Systems

Antifibrinogen, Antireflective, Antifogging Surfaces with Biocompatible Nano-Ordered Hierarchical Texture Fabricated by Layer-by-Layer Self-Assembly

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