A Novel Device For Maintaining Clear Optics during Laparoscopic Surgery

Daniel T McKenna, MD, Jennifer Choi, MD, Bruce Robb, MD, Don Selzer, MD, Samer Mattar, MD

Indiana University School of Medicine

Background: Laparoscopic surgery is plagued by the intermittent coating of the laparoscope lens with blood or fluids. This repetitive and periodic disruption leads to the removal of the laparoscope for cleaning, resulting in temporary loss of visualization and exacerbated fogging due to the change in ambient temperature. Although many options for preventing or alleviating compromised optics exist, including anti-fog solutions and the use of warm water, these are often ineffective.

Objective: To determine whether a novel, commercially available device that prevents fogging and allows for intra-abdominal cleansing of the lens, reduces the frequency of laparoscope removal and improves visualization during laparoscopic surgery. This was an observational study to determine the frequency of scope removals and washes per hour.

Description of the Device: Floshield is comprised of a plastic overtube that fits over most conventional laparoscopes. It directs the flow of CO2 over the lens of the laparoscope creating a vortex that prevents fogging and directs debris away from the lens. It also has a cleaning solution (Flo-X) that can be manually pumped over the lens to clear debris without removing the laparoscope.

Results: The frequency of laparoscope removal for cleaning was recorded during each procedure by a dedicated observer. The number of cases was 30. These cases involved foregut, bariatric, and colorectal procedures. Average operative time was 110 minutes. There were 3 scope removals for an average of .005 scope removals per hour. There were 1.5 Flo-X washes per hour. When compared with not using the device, it was found that the average bariatric or colorectal case averaged 6 removals per hour.

Conclusions: Floshield reduces the need for laparoscope removal due to fogging or contamination.

Session: Poster Presentation

Program Number: ETP033

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