Chief of Surgery, The Laser Centre Clinic, Dublin, Ireland.
Surg Innov. 2023 Dec;30(6):758-761. doi: 10.1177/15533506231206039. Epub 2023 Sep 29.
Laparoscopic Surgery is performed using carbon dioxide gas insufflated into the abdominal cavity to create a space for endoscopic visualization. During a laparoscopic surgical dissection plume is formed from electrocautery dissection. This plume contains viruses and sometimes COVID-19 viruses. The plume obscures the visual field. The unfiltered plume release is dangerous to surgeons, nurses, and patients. The loss of visualization during carbon dioxide release delays surgery. The use of carbon dioxide insufflated gas can have side effects such as C02 embolus, pain from diaphragmatic stretching, physiological complications such as respiratory infections and renal problems. The release of carbon dioxide gas into the atmosphere, unfiltered is significant. This accounts for 7% of greenhouse gases globally. This percentage is rising due to expansion of minimally invasive surgery.
The proposed system for gasless surgery was designed by algorithms of tensegrity and geodesic dome pressures.
100 simulator studies were performed to develop the device to elevate the abdominal wall to create a gas free (isobaric) space for Laparoscopic Surgery. After design freeze, 4 animal studies were performed using ethical research guidelines at Amsterdam Medical Centre Research Department, Netherlands. 3 cadaveric studies were performed using Ethical guidelines at Hackensack University Medical Centre, New Jersey, USA, to evaluate the device in a human setting.
These devices for Laparoscopic Surgery, Robotic Surgery, and Hand Assisted Laparoscopic Surgery (HALS) successfully proved that a superior intra-abdominal space can be created without carbon dioxide insufflation. The devices are patented in USA and Europe.
腹腔镜手术是通过向腹腔内注入二氧化碳气体来创建一个用于内镜可视化的空间来进行的。在腹腔镜手术切割过程中,电烙切割会形成切割烟雾。该烟雾中含有病毒,有时还含有 COVID-19 病毒。烟雾会使视野模糊。未经过滤的烟雾释放对外科医生、护士和患者都有危险。二氧化碳释放过程中视野的丧失会延迟手术。使用注入的二氧化碳气体可能会产生副作用,例如二氧化碳栓塞、膈肌拉伸引起的疼痛、呼吸感染和肾脏问题等生理并发症。未经过滤的二氧化碳气体释放到大气中是非常严重的,这占全球温室气体排放的 7%。由于微创手术的扩展,这个比例正在上升。
无气手术的拟议系统是通过张拉整体和测地线穹顶压力的算法设计的。
为了开发该设备以提升腹壁以创建用于腹腔镜手术的无气体(等压)空间,进行了 100 项模拟器研究。在设计冻结后,根据荷兰阿姆斯特丹医疗中心研究部门的伦理研究指南进行了 4 项动物研究。在美国新泽西州哈肯萨克大学医学中心,根据伦理准则进行了 3 项尸体研究,以评估该设备在人体环境中的应用。
这些用于腹腔镜手术、机器人手术和手助腹腔镜手术 (HALS) 的设备成功地证明,可以在不注入二氧化碳的情况下创建更优越的腹腔空间。该设备已在美国和欧洲获得专利。