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Quantifying Intraoperative Laparoscopic Visual Field Opacity.

Danielle Abbitt1, Bertha Ben Khallouq1, Jay Redan2

  • 1University of Central Florida College of Medicine, Department of Faculty and Academic Affairs, Orlando, Florida, USA.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|June 7, 2017
PubMed
Summary

Laparoscopic surgery lens fogging frequently requires laparoscope removal, increasing operative time and blood loss. This study quantifies the time lost due to obscured vision during laparoscopic procedures.

Keywords:
LaparoscopeLens foggingOperative time

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology
  • Patient Safety

Background:

  • Laparoscopic surgery visual fields can be obscured by lens condensation and debris.
  • This visual impairment increases the risk of surgical errors and patient injury.
  • The time lost due to obscured laparoscopic vision remains poorly quantified.

Purpose of the Study:

  • To investigate and quantify the duration laparoscope withdrawal for cleaning during laparoscopic surgery.
  • To establish a baseline for the economic impact of lens fogging in laparoscopic procedures.
  • To provide data for comparing the cost-effectiveness of anti-fogging technologies.

Main Methods:

  • Prospective, observational study involving 52 patients undergoing laparoscopic surgery.
  • Data collection included patient demographics, operative details, and complications.
  • Intraoperative recording of the frequency and total duration of laparoscope withdrawal due to obscured vision.

Main Results:

  • Laparoscope withdrawal for fogging occurred in 82% of procedures.
  • Increased operative time, estimated blood loss (EBL), and patient age correlated significantly with withdrawal frequency and duration.
  • Statistical significance was observed at P < .05 for these correlations.

Conclusions:

  • Significant correlation exists between increased laparoscope withdrawal and higher EBL, operative time, and patient age.
  • Potential explanations include age-related body composition changes, complex procedure viewing angles, and surgeon fatigue from poor visualization.
  • Quantifying time lost is crucial for understanding the impact of lens fogging and evaluating anti-fogging solutions.