Division of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Surg Endosc. 2013 Jan;27(1):333-8. doi: 10.1007/s00464-012-2434-x. Epub 2012 Jul 26.
Previous experimental research has reported minimal differences in pressure maintenance between different versions of standard insufflators (SI). However, a recent report identified potential clinical benefits with a valveless pressure barrier insufflator (PBI). We sought to perform a benchtop objective evaluation of SI and PBI systems.
A rigid box system with continuous pressure manometry was used to evaluate a PBI (Surgiquest Airseal) and two SIs (SI1 = Stryker PneumoSure High Flow Insufflator and SI2 = Storz SCB Thermoflator). Pressure maintenance of 15 mmHg was evaluated during experimental conditions of leakage from a 5 mm port site, leakage from a 12 mm port site, and continuous suction.
With leakage from the 5 mm port site, the PBI maintained pressure of >13 mmHg whereas the pressures dropped moderately with the SI1 (7-13 mmHg) and SI2 insufflators (3-7 mmHg) and did not regain goal pressure until leakage was stopped. With leakage from 12 mm port site, the PBI pressure decreased to 9-11 mmHg, whereas the SI1 and SI2 lost insufflation pressures completely. The PBI maintained pressure of >11 mmHg during continuous suction while the SI1 and SI2 lost pressure entirely, and actually showed negative pressure from air suction into the rigid box system. When evaluated statistically with the mixed model repeated measures ANOVA, the SI1 and SI2 performed similarly while the PBI maintained increased pressure.
In the experimental rigid box system, the PBI more successfully maintained pressure in response to leakage and suction than SIs.
先前的实验研究报告称，不同版本的标准注气仪（SI）之间在压力维持方面的差异很小。然而，最近的一份报告指出无阀压力屏障注气仪（PBI）具有潜在的临床益处。我们试图对 SI 和 PBI 系统进行台架客观评估。
使用具有连续压力测压的刚性盒系统来评估 PBI（Surgiquest Airseal）和两种 SI（SI1 = Stryker PneumoSure 高流量注气仪和 SI2 = Storz SCB Thermoflator）。在 5 毫米端口部位泄漏、12 毫米端口部位泄漏和连续抽吸的实验条件下，评估 15 毫米汞柱的压力维持。
在 5 毫米端口部位泄漏时，PBI 维持的压力>13 毫米汞柱，而 SI1（7-13 毫米汞柱）和 SI2 注气仪（3-7 毫米汞柱）的压力适度下降，直到停止泄漏才能恢复目标压力。在 12 毫米端口部位泄漏时，PBI 压力降至 9-11 毫米汞柱，而 SI1 和 SI2 完全失去注气压力。在连续抽吸过程中，PBI 维持的压力>11 毫米汞柱，而 SI1 和 SI2 完全失去压力，实际上显示出空气从刚性盒系统吸入的负压。使用混合模型重复测量方差分析进行统计学评估时，SI1 和 SI2 的性能相似，而 PBI 维持的压力增加。
在实验性刚性盒系统中，与 SI 相比，PBI 更成功地在响应泄漏和抽吸时维持压力。
