Kobayashi Eiji, Kakuda Mamoru, Tanaka Yusuke, Morimoto Akiko, Egawa-Takata Tomomi, Matsuzaki Shinya, Kimura Toshihiro, Ueda Yutaka, Yoshino Kiyoshi, Nakajima Kiyokazu, Kimura Tadashi
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Department of Gastrointestinal Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Surg Endosc. 2016 Jan;30(1):330-4. doi: 10.1007/s00464-015-4229-3. Epub 2015 Jun 20.
Poor visualization of the operative field due to an obscured camera lens is a problem frequently encountered while performing laparoscopic surgery. Little has been published about the prevention of lens obstruction specifically due to a contaminated camera port used for laparoscopic surgery. The aim of our study is to develop a new device, the Endowiper, for cleaning the laparoscopic port.
The new cleaner for the port's valve is made from rolled gauze. To simulate a surgical environment in the laboratory, we have used pseudo-blood to smudge the port's valve.
In order to demonstrate the efficacy and safety of the Endowiper, we compared our method using this device with three previously reported port cleaning methods. These methods included use of gauze tightly wrapped around an endoscopic dissecting cramp, a small piece of gauze grasped by an endoscopic dissecting cramp, and a swab. We repeated the performance tests 280 times, 240 using a 12-mm trocar port and 40 with a 5-mm port.
With the 12-mm port, the complete port clearance rate achieved was 83.3% by Endowiper, 56.7% by wrapped gauze, 36.7% by small gauze, and 40.0% by swab. Trouble rate encountered during the procedure was 0% by Endowiper, 1.7% by wrapped gauze, 15% by small gauze, and 90% by swab. For the 5-mm port, the complete port clearance rate was 85% by Endowiper and 20% by sterile swab. The trouble rate was 0% by Endowiper and 30% by swab. Endowiper had a significantly superior result related to clearance rate than the other three methods in both the 12- (p < 0.001) and 5-mm (p < 0.001) ports. For trouble rate, Endowiper had a significantly superior result in both the 12- (p < 0.001) and 5-mm (p < 0.01) ports.
This Endowiper will be an inexpensive device with a benefit to laparoscopic surgeons.
在进行腹腔镜手术时，由于摄像头镜头被遮挡导致手术视野不佳是一个经常遇到的问题。关于专门预防因用于腹腔镜手术的污染摄像头端口导致的镜头阻塞的报道很少。我们研究的目的是开发一种用于清洁腹腔镜端口的新装置——Endowiper。
用于端口阀门的新型清洁器由卷状纱布制成。为了在实验室模拟手术环境，我们使用假血弄脏端口阀门。
为了证明Endowiper的有效性和安全性，我们将使用该装置的方法与之前报道的三种端口清洁方法进行了比较。这些方法包括使用紧紧缠绕在内镜解剖钳上的纱布、用内镜解剖钳夹住的一小片纱布以及拭子。我们重复进行了280次性能测试，其中使用12毫米套管针端口进行了240次，使用5毫米端口进行了40次。
对于12毫米端口，Endowiper实现的完全端口清洁率为83..3%，缠绕纱布为56.7%，小纱布为36.7%，拭子为40.0%。手术过程中遇到的故障率，Endowiper为0%，缠绕纱布为1.7%，小纱布为15%，拭子为90%。对于5毫米端口，Endowiper的完全端口清洁率为85%，无菌拭子为20%。故障率，Endowiper为0%，拭子为30%。在12毫米（p<0.001）和5毫米（p<0.001）端口，Endowiper在清洁率方面的结果均显著优于其他三种方法。在故障率方面，Endowiper在12毫米（p<小于0.001）和5毫米（p<0.01）端口也有显著更好的结果。
这种Endowiper将是一种对腹腔镜外科医生有益的廉价装置。
