A novel device for cleaning the camera port during laparoscopic surgery.

AIM

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.

MATERIALS

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.

METHOD

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.

RESULTS

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.

CONCLUSION

This Endowiper will be an inexpensive device with a benefit to laparoscopic surgeons.