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Quantitative assessment of the troCarWash™ system for automated laparoscopic camera cleaning
Maaz Ahmed1, Ashok Gowda2, Fatemeh Alavi Naini3
1Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA.
Background:
Soilage of the surgical endoscope occurs frequently during minimally invasive surgery. The resultant impairment of visualization of the surgical field compromises patient safety, prolongs operative times, and frustrates surgeons. The standard practice for cleaning the surgical camera involves a disruption in the conduct of surgery by completely removing the endoscope from the field, manually cleaning its lens, treating it with a surfactant, and reinserting it into the patient; after which the surgeon resumes the procedure.
Methods:
We developed an automated solution for in vivo endoscope cleaning in minimally invasive surgery- a port that detects the position of the endoscope in its distal lumen, and precisely and automatically delivers a pressurized mist of cleaning solution to the lens of the camera. No additions to the scope and minimal user interaction with the port are required. We tested the efficacy of this troCarWash™ device in a porcine model of laparoscopy. Four board-certified general surgeons were instructed to soil and then clean the laparoscope using the device. Representative pre- and post-clean images were exported from the surgical video and clarity was graded (1) digitally by a canny edge detection algorithm, and (2) subjectively by 3 blinded, unbiased observers using a semi-quantitative scale.
Results:
We observed statistically significant improvements in clarity by each method and for each surgeon, and we noted significant correlation between digital and subjective scores.
Conclusion:
Based on these data, we conclude that the troCarWash™ effectively restored impaired visualization in a large animal model of laparoscopy.
Insights
A new automated device, troCarWash™, effectively cleans surgical endoscopes during minimally invasive surgery. This innovation improves visualization, enhancing patient safety and surgical efficiency.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Medical Devices
Background:
- Surgical endoscope soilage frequently impairs visualization during minimally invasive surgery, compromising patient safety and increasing operative times.
- Current manual cleaning methods disrupt surgical workflow, requiring endoscope removal and manual lens cleaning.
- This necessitates a more efficient and automated solution for maintaining clear visualization during procedures.
Purpose of the Study:
- To develop and evaluate an automated system for in vivo endoscope cleaning during minimally invasive surgery.
- To assess the efficacy of the troCarWash™ device in restoring endoscope lens clarity.
- To minimize disruption to surgical procedures by automating the cleaning process.
Main Methods:
- Developed the troCarWash™ port for automated, precise delivery of cleaning solution to the endoscope lens.
- Tested the device in a porcine model of laparoscopy with four board-certified general surgeons.
- Assessed image clarity using digital analysis (canny edge detection) and subjective grading by blinded observers.
Main Results:
- Statistically significant improvements in endoscope image clarity were observed.
- Both digital and subjective grading methods showed significant improvements post-cleaning.
- A significant correlation was found between digital and subjective clarity assessments.
Conclusions:
- The troCarWash™ device effectively restores impaired visualization caused by endoscope soilage.
- Automated in vivo cleaning offers a promising solution to a common challenge in minimally invasive surgery.
- This technology has the potential to enhance surgical safety and efficiency.
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