A new optic cleaning and visualization stabilizing system for endoscopic surgery

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Abstract
Clear vision is an essential requirement for safe endoscopic surgery. Sudden haemorrhage or the steam-creating application of electrocautery and lasers frequently leads to the restriction or complete loss of the endoscopic vision with consequent withdrawal and time-consuming cleaning of the optic. This deficiency in the cleaning properties of the endoscope can be hazardous especially in critical operative situations requiring the full attention of the surgeon. In co-operation with Wiest Co., Munich, Germany, a visualization stabilizing system for endoscopic surgery has been developed. The system consists of a 12 mm multifunctional tube into which the 10 mm endoscope can be inserted. Integrated in this tube are channels with small nozzles at their tips for irrigation and drying of the front glass of the optic by means of saline solution and CO2 gas. Blood and vapour can easily be washed away and the remaining liquid layer or drops at the tip of the endoscope can be blown off to avoid optical distortion. In addition, a continuous gas stream for insufflation is guided over the front lens by means of a further channel within the tube. This gas flow provides for continuous displacement of smoke and vapour from the surface of the front glass. The multifunctional tube is connected to the lines coming from the insufflator and a newly developed aspiration/irrigation device, which are linked with a signal interface. This system provides for constant intra-abdominal pressure conditions by both insufflation and exsuf-flation in case of high pressure. Continuous gas evacuation provides for cleaning of the intracorporeal gas atmosphere from smoke, dust, argon (argon beamer coagulation), and other soiling components. The system was experimentally and clinically evaluated. It showed such a high efficiency in maintaining both the intra-abdominal pressure and clear endoscopic vision that we would encourage its widespread clinical application.

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