Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan.
Int J Surg. 2012;10(1):20-4. doi: 10.1016/j.ijsu.2011.11.005. Epub 2011 Nov 30.
Conventional thoracoscopic surgery requires a camera connected to optic fibers and rigid rod lens to ensure the provision of adequate light and quality of real-time images in the operative field. However, the camera, the connected optic fibers and rigid rod lens are not disposable due to cost, which is a concern as regards potential contamination of patients. To decrease such contamination, we designed a disposable device of extremely low cost which we tested in thoracoscopic surgery in animals.
A complementary metal-oxide-semiconductor is used for obtaining real-time image at a refresh rate of 30 frames per second. A circumferential light was added by a light emitting diode. We connected wires to a universal serial bus adapter, with which the device can negotiate with a computer so as to control signal retrieval and adjustment of the light as well as focus. The device was designed to be as compact as possible. The contour resembled a conventional thoracoscope, but with no optic fibers and rigid rod lens included.
We used the devices to perform routine thoracoscopic surgical procedures, including wedge resection of the lung, lobectomy, esophagectomy, pericardiotomy and pleural biopsy in two 40-kg pigs under general anesthesia. The operating techniques were not altered while using this device.
This disposable, electrical non-fiberoptic endoscope has the potential to be easily and safely used in routine thoracoscopic surgery at a minimal cost. Further clinical evaluation will be required to demonstrate the utility in human patients.
传统的胸腔镜手术需要连接到光纤和刚性棒透镜的摄像机，以确保在手术区域提供足够的光和实时图像的质量。然而，由于成本原因，摄像机、连接的光纤和刚性棒透镜不是一次性的，这是一个潜在的患者污染问题。为了减少这种污染，我们设计了一种极其廉价的一次性设备，并用其在动物的胸腔镜手术中进行了测试。
互补金属氧化物半导体用于以每秒 30 帧的刷新率获取实时图像。通过发光二极管增加了环形光。我们将电线连接到通用串行总线适配器上，该适配器可以与计算机协商，以便控制信号检索和光的调整以及焦点。该设备被设计成尽可能紧凑。其轮廓类似于传统的胸腔镜，但不包括光纤和刚性棒透镜。
我们使用该设备在全身麻醉下对两只 40 公斤的猪进行了常规的胸腔镜手术，包括肺楔形切除术、肺叶切除术、食管切除术、心包切开术和胸膜活检。使用该设备时，操作技术没有改变。
这种一次性的、电气的非光纤内窥镜具有在最小成本下轻松、安全地用于常规胸腔镜手术的潜力。需要进一步的临床评估来证明其在人类患者中的实用性。
