{"title":"Role of dedicated port cleaning devices in laparoscopic surgery.","authors":"Shinnosuke Nagano, Shota Fujii, Kota Momose, Kotaro Yamashita, Takuro Saito, Koji Tanaka, Kazuyoshi Yamamoto, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Hidetoshi Eguchi, Yuichiro Doki, Kiyokazu Nakajima","doi":"10.1007/s00464-024-11366-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Various techniques have been used to prevent smudge on a laparoscope when inserting through trocars; however, there has been no standardized method. The purpose of this study was to compare the performance of different cleaning techniques with or without using dedicated devices, and to evaluate the features of cleaning devices.</p><p><strong>Methods: </strong>The smudge was created in the standard 12-mm and 5-mm ports using pseudo-blood, and port cleaning was attempted using 5 different methods: (1) a surgical gauze + surgical forceps, (2) a surgical gauze + laparoscopic forceps, (3) a small laparoscopic gauze + laparoscopic forceps, (4) a cylinder-type cleaner (Endo Wiper; Osaki Medical), and (5) a swab-type cleaner (Port Cleaner; Hakuzo Medical). The \"port cleaning rate\" was calculated by measuring the absorbance of remained pseudo-blood after single cleaning procedure using UV spectrophotometry. In addition, the port cleaning rate was compared between two dedicated devices after multiple (5 times) cleaning procedures.</p><p><strong>Results: </strong>The two dedicated devices had a statistically higher cleaning rate for 12-mm port than the methods using surgical gauze (p < 0.05). Regarding the 5-mm port, a swab-type cleaner showed the highest cleaning rate than the gauze method and a cylinder-type cleaner (p < 0.05). After multiple cleaning procedures for 12-mm port, cleaning rate of a swab-type cleaner decreased by an average of 5.4% (p = 0.044), but cleaning rate did not decrease for a cylinder-type cleaner. Regarding the 5-mm port, cleaning rate statistically decreased for both two dedicated devices (p < 0.01).</p><p><strong>Conclusion: </strong>Higher port cleaning rates were observed in techniques using dedicated devices. A swab-type cleaner had better port cleaning rate in single use, especially for the 5-mm port. A cylinder-type cleaner showed higher durability in cleaning 12-mm port. The features of these dedicated devices should be well understood, and cleaning methods should be selected according to the environment and surgical techniques.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Endoscopy And Other Interventional Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00464-024-11366-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Various techniques have been used to prevent smudge on a laparoscope when inserting through trocars; however, there has been no standardized method. The purpose of this study was to compare the performance of different cleaning techniques with or without using dedicated devices, and to evaluate the features of cleaning devices.
Methods: The smudge was created in the standard 12-mm and 5-mm ports using pseudo-blood, and port cleaning was attempted using 5 different methods: (1) a surgical gauze + surgical forceps, (2) a surgical gauze + laparoscopic forceps, (3) a small laparoscopic gauze + laparoscopic forceps, (4) a cylinder-type cleaner (Endo Wiper; Osaki Medical), and (5) a swab-type cleaner (Port Cleaner; Hakuzo Medical). The "port cleaning rate" was calculated by measuring the absorbance of remained pseudo-blood after single cleaning procedure using UV spectrophotometry. In addition, the port cleaning rate was compared between two dedicated devices after multiple (5 times) cleaning procedures.
Results: The two dedicated devices had a statistically higher cleaning rate for 12-mm port than the methods using surgical gauze (p < 0.05). Regarding the 5-mm port, a swab-type cleaner showed the highest cleaning rate than the gauze method and a cylinder-type cleaner (p < 0.05). After multiple cleaning procedures for 12-mm port, cleaning rate of a swab-type cleaner decreased by an average of 5.4% (p = 0.044), but cleaning rate did not decrease for a cylinder-type cleaner. Regarding the 5-mm port, cleaning rate statistically decreased for both two dedicated devices (p < 0.01).
Conclusion: Higher port cleaning rates were observed in techniques using dedicated devices. A swab-type cleaner had better port cleaning rate in single use, especially for the 5-mm port. A cylinder-type cleaner showed higher durability in cleaning 12-mm port. The features of these dedicated devices should be well understood, and cleaning methods should be selected according to the environment and surgical techniques.
期刊介绍：
Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research.
Topics covered in the journal include:
-Surgical aspects of:
Interventional endoscopy,
Ultrasound,
Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology,
-Gastroenterologic surgery
-Thoracic surgery
-Traumatic surgery
-Orthopedic surgery
-Pediatric surgery
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