Surgical smoke management for minimally invasive (micro)endoscopy: an experimental study

Area of Science:

• Ophthalmology
• Surgical Technology
• Medical Engineering

Background:

• Investigates surgical smoke production during minimally invasive microendoscopic procedures.
• Addresses challenges of smoke removal from small endoscopic cavities via 20 G (0.9 mm) microports.

Purpose of the Study:

• To propose and test a technical solution for efficient surgical smoke evacuation in microendoscopic procedures.
• To analyze the feasibility and safety of smoke management in confined surgical spaces.

Main Methods:

• Developed an in vitro laboratory model using transparent plastic cavities and pressure sensors.
• Utilized a Kalium-Titanyl-Phosphate (KTP) laser to generate surgical smoke from bovine scleral tissue.
• Implemented a controlled system for gas insufflation and suction to manage intracavital pressure.

Main Results:

• Analyzed smoke-related issues in small cavities during laser ablation and electrosurgery.
• Established and tested a theoretical and mechatronic laboratory model for smoke evacuation.
• Identified the need for a novel suction tube design to prevent obstruction by smoke particles.

Conclusions:

• Surgical smoke evacuation via 20 G ports in small endoscopic cavities can be safe and efficient with adequate gas exchange.
• Maintaining low, constant intracavital pressure is crucial for surgical visibility and minimizing smoke toxicity.
• A specialized suction tube design is essential for effective smoke particle management.