James A Rydlewicz, MD, Andrew J Suzo, BS, Dean J Mikami, MD, Bradley J Needleman, MD. The Ohio State University Wexner Medical Center.
Introduction: The Airseal(tm) (SurgiQuest, Milford, CT) system consists of a surgical trocar, tubing/filter set, and re-circulation and filtration control unit used to create and maintain a port of entry during laparoscopic surgery. The device enables peritoneal access with a novel mechanism to maintain pneumoperitoneum. Specifically, it creates a pressure barrier, which acts as an invisible seal to maintain pneumoperitoneum during the course of surgery.
Aim: This is a post-market study of the Airseal(tm) system to further establish the safety, efficacy, and utility of the Airseal(tm) trocar in laparoscopic bariatric surgery.
Methods: We randomly selected 100 patients who underwent a Roux-en-Y gastric bypass (RNY) with a 12mm AirSeal trocar and 100 patients who underwent a RNY with a 10mm standard VersaStep (co, city, state) from October 1, 2005 through February 1, 2013, 100. A retrospective chart review was then performed to collect operative times, blood loss, hemodynamic values, and end tidal CO2, which were compared between the two groups.
Results: In both groups, a similar surgical technique was used . In the AirSeal group, patients had a mean BMI of 50.0 (range 40.4 – 84.5) and mean age of 45.4 (range 18-69). Mean operative time was 83.6 mins (range 46 – 130) with mean estimated blood loss of 35.1 cc. In the VersaStep group, patients had a mean BMI of 56.6 (range 36.4 – 81.4) and mean age of 46.9 (range 21 – 67). Mean operative time was 95.9 mins (range 57 – 200) with mean estimated blood loss of 47.5 cc. Both groups had similar hemodynamic profiles (BP, HR), ventilator settings, and end tidal CO2. The Airseal(tm) system group saved 12.3 mins in the operating room on average. This saves about $345.00 per case on operating room time.
Conclusion: The Airseal(tm) system in laparoscopic bariatric surgery is safe and leads to decreased operative times. This can potentially decrease the overall cost of surgery by decreasing operating room costs.