MAINTENANCE OF CLEAR VISION DURING LAPAROSCOPIC SURGERY

Laparoscopic surgeons will be familiar with the frustration generated by periodic interruptions to the operation caused by an impaired view through the laparoscope. If accidental bleeding occurs, a poor view of the operative field may threaten conversion to open surgery, or if se vere, the patient's life, Maintenance of unimpeded Visual clarity is t herefore of prime importance during endoscopic surgery, but to date th ere has been little objective evidence documenting how this may be ach ieved. Investigations were conducted to identify conditions that hinde r vision during endoscopic surgery, and some possible solutions were e xperimentally evaluated in inanimate and live animal models. it was co ncluded that to prevent the condensation of water vapour on the optica l viewing surface an integrated, monitored electrical heating system i s required. To maintain ideal visual conditions, insufflated gas shoul d continuously flow directly over the front lens and be warmed and hum idified, The optical system should also be capable of rinsing and dryi ng the lens, and able to exsufflate smoke and particulate debris manuf actured during electrocautery. This information was used in co-operati on with an industry partner for the development of a multi-function op tical system that provides continuously unencumbered acuity under all situations encountered in the laparoscopic environment.