A NEW OPTIC CLEANING AND VISUALIZATION STABILIZING SYSTEM FOR ENDOSCOPIC SURGERY

Clear vision is an essential requirement for safe endoscopic surgery. Sudden haemorrhage or the steam-creating application of electrocautery and lasers frequently leads to the restriction or complete loss of th e endoscopic vision with consequent withdrawal and time-consuming clea ning of the optic. This deficiency in the cleaning properties of the e ndoscope can be hazardous especially in critical operative situations requiring the full attention of the surgeon. In co-operation with Wies t Co., Munich, Germany, a visualization stabilizing system for endosco pic surgery has been developed. The system consists of a 12 mm multifu nctional tube into which the 10 mm endoscope can be inserted. Integrat ed in this tube are channels with small nozzles at their tips for irri gation and drying of the front glass of the optic by means of saline s olution and CO2 gas. Blood and vapour can easily be washed away and th e remaining liquid layer or drops at the tip of the endoscope can be b lown off to avoid optical distortion. In addition, a continuous gas st ream for insufflation is guided over the front lens by means of a furt her channel within the tube. This gas flow provides for continuous dis placement of smoke and vapour from the surface of the front glass. The multifunctional tube is connected to the lines coming from the insuff lator and a newly developed aspiration/irrigation device, which are li nked with a signal interface. This system provides for constant intra- abdominal pressure conditions by both insufflation and exsufflation in case of high pressure. Continuous gas evacuation provides for cleanin g of the intracorporeal gas atmosphere from smoke, dust, argon (argon beamer coagulation), and other soiling components. The system was expe rimentally and clinically evaluated. It showed such a high efficiency in maintaining both the intra-abdominal pressure and clear endoscopic vision that we would encourage its widespread clinical application.