新規耳科・神経耳科手術用灌流システム：水分消費量の削減
Jumah G Ahmad1, Adam Karkoutli, Samira Takkoush
1Department of Otolaryngology-Head and Neck Surgery, University of Utah Health, Salt Lake City, UT.
Objective:
To describe a novel sterile fluid irrigation system for otologic/neurotologic surgery and compare the consumption of fluid using different techniques to identify the most fluid-efficient system.
Patients:
Patients undergoing cochlear implant (CI) or translabyrinthine skull base (TL) surgery at a tertiary referral center using different irrigation techniques from October 2022 to December 2024, with detailed intraoperative documentation of sterile fluid utilization.
Interventions:
CI or TL surgery using different irrigation techniques.
Main Outcome Measures:
A comparison of the volume of sterile irrigation fluid (in liters [L]) used during CI or TL surgery across the following irrigation techniques: manual suction irrigation (MSI), automated cassette suction irrigation (ASI), and automated cassette drill irrigation (ADI). The Mann-Whitney U test was used to compare medians between groups.
Results:
For CI surgery, the median volume of sterile irrigation fluid used was 4 L [interquartile range (IQR): 4-4, n=10] for MSI, 2 L (IQR: 2-2.5, n=5) for ASI, and 0.5 L (IQR: 0.5-0.5, n=10) for ADI (P<0.01). For TL surgery, the median volume of sterile irrigation fluid used was 10 L (IQR: 10-10, n=7) for MSI, 5.45 L (IQR: 4-5.72, n=5) for ASI, and 1.5 L (IQR: 1-2, n=10) for ADI (P<0.01). There were no irrigation-related complications.
Conclusions:
The volume of fluid irrigation used during otologic/neurotologic surgery varies widely depending on the technique used with ADI conserving the most fluid, followed by ASI and MSI, respectively. The novel ASI system promotes resource conservation, sustainability and surgical technologists' ease of use.
