An Isolator System for minimally invasive surgery: the new design
Identifieur interne : 003884 ( Main/Merge ); précédent : 003883; suivant : 003885An Isolator System for minimally invasive surgery: the new design
Auteurs : Tim Horeman [Pays-Bas] ; Frank-Willem Jansen [Pays-Bas] ; Jenny Dankelman [Pays-Bas]Source :
- Surgical Endoscopy [ 0930-2794 ] ; 2010.
Abstract
The risk of obtaining a postsurgical infection depends highly on the air quality surrounding the exposed tissue, surgical instruments, and materials. Many isolators for open surgery have been invented to create a contained sterile volume around the exposed tissue. With the use of an isolator, a surgical procedure can be performed outside sterile environments. The goal of this study was to design an Isolator System (IS) for standard laparoscopic instruments while instrument movements are not restricted.
The developed IS consists of a sleeve to protect the instrument shaft and tip and a special balloon to protect the incision and trocar tube. A coupling mechanism connected at the sleeve allows instrument changes without contamination of the isolated parts. Smoke tests were performed to show that outside air does not enter the new IS during a simulated laparoscopic procedure. Eight test runs and one baseline run inside a contained volume filled with thick smoke were performed to investigate whether smoke particles entered the Isolator System. Filters were used to identify smoke entering the Isolator System.
Seven filters showed no trace of smoke particles. In one test run, a part of the IS loosened and a small brown spot was visible. The filter from the baseline run was completely covered with a thick layer of particles, proving the effectiveness of the test. During all test runs, the isolated instrument was successfully locked on and unlocked from the isolated trocar. Instrument movements gave no complications. After removal of the isolated instrument, it took three novices an average of 3.1 (standard deviation (SD), 0.7) seconds to replace it correctly on the isolated trocar.
The designed IS for laparoscopy can increase sterility in environments where sterility cannot be guaranteed. The current design is developed for laparoscopy, but it can easily be adapted for other fields in minimally invasive surgery.
Url:
DOI: 10.1007/s00464-009-0877-5
PubMed: 20108141
PubMed Central: 2895887
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<author><name sortKey="Horeman, Tim" sort="Horeman, Tim" uniqKey="Horeman T" first="Tim" last="Horeman">Tim Horeman</name>
<affiliation wicri:level="1"><nlm:aff id="Aff1">Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE), Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE), Delft University of Technology, Mekelweg 2, 2628 CD Delft</wicri:regionArea>
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<author><name sortKey="Jansen, Frank Willem" sort="Jansen, Frank Willem" uniqKey="Jansen F" first="Frank-Willem" last="Jansen">Frank-Willem Jansen</name>
<affiliation wicri:level="3"><nlm:aff id="Aff2">Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands</nlm:aff>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">An Isolator System for minimally invasive surgery: the new design</title>
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<affiliation wicri:level="1"><nlm:aff id="Aff1">Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE), Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands</nlm:aff>
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<author><name sortKey="Jansen, Frank Willem" sort="Jansen, Frank Willem" uniqKey="Jansen F" first="Frank-Willem" last="Jansen">Frank-Willem Jansen</name>
<affiliation wicri:level="3"><nlm:aff id="Aff2">Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
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<author><name sortKey="Dankelman, Jenny" sort="Dankelman, Jenny" uniqKey="Dankelman J" first="Jenny" last="Dankelman">Jenny Dankelman</name>
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<series><title level="j">Surgical Endoscopy</title>
<idno type="ISSN">0930-2794</idno>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The risk of obtaining a postsurgical infection depends highly on the air quality surrounding the exposed tissue, surgical instruments, and materials. Many isolators for open surgery have been invented to create a contained sterile volume around the exposed tissue. With the use of an isolator, a surgical procedure can be performed outside sterile environments. The goal of this study was to design an Isolator System (IS) for standard laparoscopic instruments while instrument movements are not restricted.</p>
</sec>
<sec><title>Methods</title>
<p>The developed IS consists of a sleeve to protect the instrument shaft and tip and a special balloon to protect the incision and trocar tube. A coupling mechanism connected at the sleeve allows instrument changes without contamination of the isolated parts. Smoke tests were performed to show that outside air does not enter the new IS during a simulated laparoscopic procedure. Eight test runs and one baseline run inside a contained volume filled with thick smoke were performed to investigate whether smoke particles entered the Isolator System. Filters were used to identify smoke entering the Isolator System.</p>
</sec>
<sec><title>Results</title>
<p>Seven filters showed no trace of smoke particles. In one test run, a part of the IS loosened and a small brown spot was visible. The filter from the baseline run was completely covered with a thick layer of particles, proving the effectiveness of the test. During all test runs, the isolated instrument was successfully locked on and unlocked from the isolated trocar. Instrument movements gave no complications. After removal of the isolated instrument, it took three novices an average of 3.1 (standard deviation (SD), 0.7) seconds to replace it correctly on the isolated trocar.</p>
</sec>
<sec><title>Conclusions</title>
<p>The designed IS for laparoscopy can increase sterility in environments where sterility cannot be guaranteed. The current design is developed for laparoscopy, but it can easily be adapted for other fields in minimally invasive surgery.</p>
</sec>
</div>
</front>
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