Evaluation of Peritoneal Particle Escape in a Valve-Less Trocar System
EAES Academy. Robertson D. 07/05/22; 366556; P299
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Abstract
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During the COVID-19 pandemic, laparoscopic surgical procedures were delayed due to the possibility of viral transmission to surgical staff. Although the risk of transmission was shown to be low, surgical staff has become more concerned about of the health impacts of viruses and other particles in peritoneal gas during laparoscopic procedures.
For some surgeons, this concern extended to the Airseal Insufflator System. This is a valve-less trocar system that is promoted to have better pneumo-peritoneal stability and better smoke evacuation. However, due to the lack of valves, it is suspected that peritoneal particles could escape into the surgical workspace.
Aims
Therefore, the aim of this study was compare the number of particles that escape from the Airseal trocar with a conventional trocar using a bench-top setup.
Methods
The setup consisted of two stacked containers with a flexible abdomen phantom to create an airtight seal with the trocars, as seen in figure 1. The number of 0.3 µm particles in the containers was measured using a particle counter, a particle generator was used to create sodium chloride salt aerosol particles in the lower box. The number of particles in the lower box remained constant at 8*10^5 particles.
The Airseal Insufflator insufflated the lower container, while connected to the Airseal 12-mm trocar or the conventional 12-mm disposable trocar. Therefore, the only pathway for the particles from the lower to the upper container was through the trocars.
Results
The preliminary results show a higher rate of particle escape when using the Airseal trocar compared to the conventional trocar. During measurements on the Airseal trocar, the number of particles in the upper container increased from 5.5*10^4 to 20*10^4. For the standard trocar, the number of particles increased from 3.4*10^4 to 4.1*10^4.
Conclusion(s)
During this study, some influential conditions were tested to measure the trocars’ performance. The next steps are to include additional testing conditions such as pressure differences in the lower container, to simulate patient breathing. Looking at the difference in performance of the trocars, we find that the Airseal trocar is unable to prevent all particles from escaping the peritoneal cavity.
For some surgeons, this concern extended to the Airseal Insufflator System. This is a valve-less trocar system that is promoted to have better pneumo-peritoneal stability and better smoke evacuation. However, due to the lack of valves, it is suspected that peritoneal particles could escape into the surgical workspace.
Aims
Therefore, the aim of this study was compare the number of particles that escape from the Airseal trocar with a conventional trocar using a bench-top setup.
Methods
The setup consisted of two stacked containers with a flexible abdomen phantom to create an airtight seal with the trocars, as seen in figure 1. The number of 0.3 µm particles in the containers was measured using a particle counter, a particle generator was used to create sodium chloride salt aerosol particles in the lower box. The number of particles in the lower box remained constant at 8*10^5 particles.
The Airseal Insufflator insufflated the lower container, while connected to the Airseal 12-mm trocar or the conventional 12-mm disposable trocar. Therefore, the only pathway for the particles from the lower to the upper container was through the trocars.
Results
The preliminary results show a higher rate of particle escape when using the Airseal trocar compared to the conventional trocar. During measurements on the Airseal trocar, the number of particles in the upper container increased from 5.5*10^4 to 20*10^4. For the standard trocar, the number of particles increased from 3.4*10^4 to 4.1*10^4.
Conclusion(s)
During this study, some influential conditions were tested to measure the trocars’ performance. The next steps are to include additional testing conditions such as pressure differences in the lower container, to simulate patient breathing. Looking at the difference in performance of the trocars, we find that the Airseal trocar is unable to prevent all particles from escaping the peritoneal cavity.
During the COVID-19 pandemic, laparoscopic surgical procedures were delayed due to the possibility of viral transmission to surgical staff. Although the risk of transmission was shown to be low, surgical staff has become more concerned about of the health impacts of viruses and other particles in peritoneal gas during laparoscopic procedures.
For some surgeons, this concern extended to the Airseal Insufflator System. This is a valve-less trocar system that is promoted to have better pneumo-peritoneal stability and better smoke evacuation. However, due to the lack of valves, it is suspected that peritoneal particles could escape into the surgical workspace.
Aims
Therefore, the aim of this study was compare the number of particles that escape from the Airseal trocar with a conventional trocar using a bench-top setup.
Methods
The setup consisted of two stacked containers with a flexible abdomen phantom to create an airtight seal with the trocars, as seen in figure 1. The number of 0.3 µm particles in the containers was measured using a particle counter, a particle generator was used to create sodium chloride salt aerosol particles in the lower box. The number of particles in the lower box remained constant at 8*10^5 particles.
The Airseal Insufflator insufflated the lower container, while connected to the Airseal 12-mm trocar or the conventional 12-mm disposable trocar. Therefore, the only pathway for the particles from the lower to the upper container was through the trocars.
Results
The preliminary results show a higher rate of particle escape when using the Airseal trocar compared to the conventional trocar. During measurements on the Airseal trocar, the number of particles in the upper container increased from 5.5*10^4 to 20*10^4. For the standard trocar, the number of particles increased from 3.4*10^4 to 4.1*10^4.
Conclusion(s)
During this study, some influential conditions were tested to measure the trocars’ performance. The next steps are to include additional testing conditions such as pressure differences in the lower container, to simulate patient breathing. Looking at the difference in performance of the trocars, we find that the Airseal trocar is unable to prevent all particles from escaping the peritoneal cavity.
For some surgeons, this concern extended to the Airseal Insufflator System. This is a valve-less trocar system that is promoted to have better pneumo-peritoneal stability and better smoke evacuation. However, due to the lack of valves, it is suspected that peritoneal particles could escape into the surgical workspace.
Aims
Therefore, the aim of this study was compare the number of particles that escape from the Airseal trocar with a conventional trocar using a bench-top setup.
Methods
The setup consisted of two stacked containers with a flexible abdomen phantom to create an airtight seal with the trocars, as seen in figure 1. The number of 0.3 µm particles in the containers was measured using a particle counter, a particle generator was used to create sodium chloride salt aerosol particles in the lower box. The number of particles in the lower box remained constant at 8*10^5 particles.
The Airseal Insufflator insufflated the lower container, while connected to the Airseal 12-mm trocar or the conventional 12-mm disposable trocar. Therefore, the only pathway for the particles from the lower to the upper container was through the trocars.
Results
The preliminary results show a higher rate of particle escape when using the Airseal trocar compared to the conventional trocar. During measurements on the Airseal trocar, the number of particles in the upper container increased from 5.5*10^4 to 20*10^4. For the standard trocar, the number of particles increased from 3.4*10^4 to 4.1*10^4.
Conclusion(s)
During this study, some influential conditions were tested to measure the trocars’ performance. The next steps are to include additional testing conditions such as pressure differences in the lower container, to simulate patient breathing. Looking at the difference in performance of the trocars, we find that the Airseal trocar is unable to prevent all particles from escaping the peritoneal cavity.
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