Women's Health Directorate, University Hospitals Dorset NHS Foundation Trust, Bournemouth, England.
J Obstet Gynaecol. 2024 Dec;44(1):2375590. doi: 10.1080/01443615.2024.2375590. Epub 2024 Jul 22.
Operative vision can frequently be critically reduced during laparoscopic surgery by condensation and other matter accumulating on the distal laparoscope lens. By delivering saline and carbon dioxide across the lens, the OpClear system is designed to maintain operative vision without needing scope removal for lens cleaning. This study evaluates the system's efficacy in providing high-level visual acuity during laparoscopic hysterectomy while examining its utility through its impact on operative duration.
A retrospective audit compared efficacy and utility for the three years before and after the implementation of OpClear in a single unit. Thirty-three cases were reviewed pre-OpClear, while 82 cases were analysed in the post-OpClear group. All cases involved routine total laparoscopic hysterectomies (TLH) performed by the same surgeon (AT) with similar complexity levels.
The OpClear system provided a consistently high level of visual acuity throughout the laparoscopic procedures. Scope removals, which typically result in non-productive operating time, were virtually eliminated. Consequently, in highly comparable cases, OpClear usage resulted in a 17-minute reduction in operating time over cases performed without the device. Additionally, in the OpClear group, there were trends towards reduced blood loss and shorter hospital stays, with patients in the OpClear group being discharged on first rather than second postoperatively.
The findings of this audit suggest that the OpClear system provides continuous high-level vision during laparoscopic hysterectomy. Further, reducing periods of non-productive time associated with scope removal for cleaning resulted in shorter operating times. Thus, the system has the potential to enhance safety, improve theatre utilisation and alleviate some of the surgical stresses associated with laparoscopic surgery.
在腹腔镜手术中，由于冷凝和其他物质积聚在腹腔镜远端镜头上，手术视野经常会严重受限。OpClear 系统旨在通过向镜头输送生理盐水和二氧化碳来维持手术视野，而无需为镜头清洁而移除镜头。本研究评估了该系统在提供高水平腹腔镜子宫切除术视觉效果方面的功效，同时通过其对手术时间的影响来检查其效用。
一项回顾性审计比较了在一个单位实施 OpClear 前后三年的疗效和实用性。在 OpClear 前，回顾了 33 例病例，而在 OpClear 后，分析了 82 例病例。所有病例均涉及由同一位外科医生（AT）进行的常规全腹腔镜子宫切除术（TLH），具有相似的复杂程度。
OpClear 系统在整个腹腔镜手术过程中提供了始终如一的高水平视觉效果。通常会导致非生产性手术时间的镜头移除几乎被消除。因此，在高度可比的情况下，与没有使用该设备的手术相比，OpClear 的使用使手术时间缩短了 17 分钟。此外，在 OpClear 组中，出血量减少和住院时间缩短的趋势更为明显，OpClear 组的患者术后第一天即可出院，而不是第二天。
本审计的结果表明，OpClear 系统在腹腔镜子宫切除术中提供持续的高水平视觉效果。此外，减少因清洁而移除镜头导致的非生产性时间可以缩短手术时间。因此，该系统有可能提高安全性、提高手术室利用率，并减轻与腹腔镜手术相关的一些手术压力。
