一种新型等压(无气)腹腔镜手术装置。

IF 1.2 4区 医学 Q3 SURGERY
Surgical Innovation Pub Date : 2023-12-01 Epub Date: 2023-09-29 DOI:10.1177/15533506231206039
Patrick F Leahy
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引用次数: 0

摘要

背景:腹腔镜手术是通过将二氧化碳气体吹入腹腔来创建内窥镜可视化空间来进行的。在腹腔镜手术中,电烙术会形成羽状物。这种羽流含有病毒,有时还含有新冠肺炎病毒。烟羽遮蔽了视野。未经过滤的烟羽释放对外科医生、护士和病人都是危险的。二氧化碳释放过程中失去视觉效果会延迟手术。使用二氧化碳吹入气体可能会产生副作用,如二氧化碳栓塞、膈肌拉伸疼痛、生理并发症,如呼吸道感染和肾脏问题。未经过滤的二氧化碳气体释放到大气中是非常重要的。这占全球温室气体的7%。由于微创手术的扩大,这一比例正在上升。方法:所提出的无气手术系统是通过张力整体和测地线圆顶压力的算法设计的。实验结果:进行了100项模拟研究,开发了一种提升腹壁的装置,为腹腔镜手术创造一个无气体(等压)空间。设计冻结后,在荷兰阿姆斯特丹医学中心研究部使用伦理研究指南进行了4项动物研究。在美国新泽西州哈肯萨克大学医学中心使用伦理指南进行了3项尸体研究,以在人体环境中评估该设备。结论:这些用于腹腔镜手术、机器人手术和手辅助腹腔镜手术(HALS)的设备成功地证明了在没有二氧化碳吹入的情况下可以创造优越的腹腔内空间。这些设备在美国和欧洲获得专利。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Novel Isobaric (Gas-Less) Laparoscopic Surgery Device.

Background: Laparoscopic Surgery is performed using carbon dioxide gas insufflated into the abdominal cavity to create a space for endoscopic visualization. During a laparoscopic surgical dissection plume is formed from electrocautery dissection. This plume contains viruses and sometimes COVID-19 viruses. The plume obscures the visual field. The unfiltered plume release is dangerous to surgeons, nurses, and patients. The loss of visualization during carbon dioxide release delays surgery. The use of carbon dioxide insufflated gas can have side effects such as C02 embolus, pain from diaphragmatic stretching, physiological complications such as respiratory infections and renal problems. The release of carbon dioxide gas into the atmosphere, unfiltered is significant. This accounts for 7% of greenhouse gases globally. This percentage is rising due to expansion of minimally invasive surgery.

Methodology: The proposed system for gasless surgery was designed by algorithms of tensegrity and geodesic dome pressures.

Experiment results: 100 simulator studies were performed to develop the device to elevate the abdominal wall to create a gas free (isobaric) space for Laparoscopic Surgery. After design freeze, 4 animal studies were performed using ethical research guidelines at Amsterdam Medical Centre Research Department, Netherlands. 3 cadaveric studies were performed using Ethical guidelines at Hackensack University Medical Centre, New Jersey, USA, to evaluate the device in a human setting.

Conclusions: These devices for Laparoscopic Surgery, Robotic Surgery, and Hand Assisted Laparoscopic Surgery (HALS) successfully proved that a superior intra-abdominal space can be created without carbon dioxide insufflation. The devices are patented in USA and Europe.

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来源期刊
Surgical Innovation
Surgical Innovation 医学-外科
CiteScore
2.90
自引率
0.00%
发文量
72
审稿时长
6-12 weeks
期刊介绍: Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).
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