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Surgical Endoscopy
Published in: Surgical Endoscopy 3/2018

01-03-2018 | New Technology

Prospective, randomized comparison of the use of FloShield Air System® versus the reference technique (water + povidone-iodine solution) during gynecologic endoscopic surgery to evaluate the operative lens vision quality

Authors: S. Bendifallah, E. Salakos, I. Naoura, P. Aristizabal, E. Furet, S. Zilberman, M. Ballester, E. Darai

Published in: Surgical Endoscopy | Issue 3/2018

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Abstract

Background

The FloShield Air System® is a new device for laparoscopic surgery that utilizes a continuous dry CO2 gas flow over the scope to defog the lens and protect it from condensation, debris and smoke. We set out to compare the performance and efficiency of the device in terms of operative lens vision quality (OLVQ) with the reference technique (water + povidone-iodine (PVI) solution) during gynecologic laparoscopic surgery.

Materials and methods

We conducted a single-center randomized prospective study between March and June 2016 (Trials Database Registration NCT02702531) including 53 patients undergoing gynecologic laparoscopic surgery with water + PVI solution and 51 patients who underwent surgical procedures with the FloShield Air System.
The primary outcome measure was the number of laparoscope removals during surgery. Secondary outcome measures were the time to clean, assessment of the quality of vision, the correlation between the laparoscopic surgical complexity and outcomes, and cost effectiveness.

Results

Overall, the mean patient age was 43.2 years (range 22–86) and body mass index 24.8 (range 16.8–42.7). The mean number of endoscope removals during surgery was 7.0 (range 0–37) in the water + PVI solution arm and 2.8 (range 0–12) in the FloShield Air System® arm. The number of removals was significantly lower in the FloShield arm (p < 0.001). No difference in time to clean, quality of vision, level of laparoscopic procedure complexity, or cost was observed between the groups.

Conslusions

The FloShield Air System® resulted in fewer laparoscopic lens removals than the water + PVI solution solution, but that there was no difference in quality of vision, cleaning time or cost, especially for the more complex surgery.
Appendix
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Literature
1.
Chung RS, Rowland DY, Li P, Diaz J (1999) A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg 177(3):250–256CrossRefPubMed
2.
Karthikesalingam A, Markar SR, Holt PJE, Praseedom RK (2010) Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia. Br J Surg 97(1):4–11CrossRefPubMed
3.
Canis M, Mage G, Wattiez A et al (1994) The role of laparoscopic surgery in gynecologic oncology. Curr Opin Obstet Gynecol 6(3):210–214CrossRefPubMed
4.
Kehoe SM, Ramirez PT, Abu-Rustum NR (2007) Innovative laparoscopic surgery in gynecologic oncology. Curr Oncol Rep 9(6):472–477CrossRefPubMed
5.
Chen S-H, Li Z-A, Du X-P (2016) Robot-assisted versus conventional laparoscopic surgery in the treatment of advanced stage endometriosis: a meta-analysis. Clin Exp Obstet Gynecol 43(3):422–426PubMed
6.
7.
Moawad NS, Santamaria E, Rhoton-Vlasak A, Lightsey JL (2016) Laparoscopic ovarian transposition before pelvic cancer treatment: ovarian function and fertility preservation. J Minim Invasive Gynecol. doi:10.​1016/​j.​jmig.​2016.​08.​831
8.
Lawrentschuk N, Fleshner NE, Bolton DM (2010) Laparoscopic lens fogging: a review of etiology and methods to maintain a clear visual field. J Endourol Endourol Soc 24(6):905–913CrossRef
9.
10.
Yong N, Grange P, Eldred-Evans D (2016) Impact of laparoscopic lens contamination in operating theaters: a study on the frequency and duration of lens contamination and commonly utilized techniques to maintain clear vision. Surg Laparosc Endosc Percutan Tech 26(4):286–289CrossRefPubMed
11.
Mowbray N, Ansell J, Warren N et al (2013) Is surgical smoke harmful to theater staff? A systematic review. Surg Endosc 27(9):3100–3107CrossRefPubMed
12.
Mohammadhosseini B (2010) Povidone-iodine surgical scrub solution prevents fogging of the scope’s lens during laparoscopic surgery. Surg Endosc 24(6):1498–1499; author reply 1500
13.
Balayssac D, Pereira B, Bazin J-E et al (2016) Warmed and humidified carbon dioxide for abdominal laparoscopic surgery: meta-analysis of the current literature. Surg Endosc. doi:10.​1007/​s00464-016-4866-1 PubMed
14.
Binda MM (2015) Humidification during laparoscopic surgery: overview of the clinical benefits of using humidified gas during laparoscopic surgery. Arch Gynecol Obstet 292(5):955–971CrossRefPubMedPubMedCentral
15.
Van Deurzen DFP, Mannaerts GHH, Jakimowicz JJ, Cuschieri A (2005) Prevention of lens condensation in laparoscopic surgery by lens heating with a thermos flask. Surg Endosc 19(2):299–300CrossRefPubMed
16.
Piromchai P, Kasemsiri P, Thanaviratananich S (2011) Alternative agents to prevent fogging in head and neck endoscopy. Clin Med Insights Ear Nose Throat 4:1–4PubMedPubMedCentral
17.
18.
Iyer R, Gentry-Maharaj A, Nordin A et al (2015) Predictors of complications in gynaecological oncological surgery: a prospective multicentre study (UKGOSOC-UK gynaecological oncology surgical outcomes and complications). Br J Cancer 112(3):475–484CrossRefPubMed
19.
Dexter F, Traub RD (2002) How to schedule elective surgical cases into specific operating rooms to maximize the efficiency of use of operating room time. Anesth Analg 94(4):933–942, table of contents
20.
21.
22.
World Health Organization (2002) Female sterilization: a guide to provision of services. WHO, Geneva
23.
Kitano S, Tomikawa M, Iso Y et al (1992) A safe and simple method to maintain a clear field of vision during laparoscopic cholecystectomy. Surg Endosc 6(4):197–198CrossRefPubMed
Metadata
Title
Prospective, randomized comparison of the use of FloShield Air System® versus the reference technique (water + povidone-iodine solution) during gynecologic endoscopic surgery to evaluate the operative lens vision quality
Authors
S. Bendifallah
E. Salakos
I. Naoura
P. Aristizabal
E. Furet
S. Zilberman
M. Ballester
E. Darai
Publication date
01-03-2018
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 3/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5642-6

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