Characterisation of trocar associated gas leaks during laparoscopic surgery
Daniel Robertson, Frank Sterke, Willem van Weteringen, Alberto Arezzo, Yoav Mintz, Felix Nickel, Luigi Boni, Ludovica Baldari, Thomas Carus, Manish Chand, Hans F. Fuchs, Fanny Ficuciello, Stefania Marconi, George Mylonas, Young‐Woo Kim, Kiyokazu Nakajima, Marlies P. Schijven, Pietro Valdastri, Chen Sagiv, Pietro Mascagni, Piotr Myśliwiec, Wanda Petz, Francisco M. Sánchez‐Margallo, Tim Horeman
Abstract
BACKGROUND: ) that could become contaminated with viruses and surgical smoke. Medical staff is potentially exposed when this gas leaks into the operating room through the instruments and past trocar valves. No detailed studies currently exist that have quantified these leakage pathways. Therefore, the goal of this study was to quantify the gas leakages through trocars and instruments, during minimally invasive procedures. METHODS: A model of the surgical environment was created, consisting of a rigid container with an interface for airtight clamping of laparoscopic equipment such as trocars and surgical instruments. The model was insufflated to 15 mm Hg using a pressure generator and a pneumotachograph measured the equipment gas leak. A protocol of several use cases was designed to simulate the motions and forces the surgeon exerts on the trocar during surgery. RESULTS: Twenty-three individual trocars and twenty-six laparoscopic instruments were measured for leakage under the different conditions of the protocol. Trocar leakages varied between 0 L/min and more than 30 L/min, the instruments revealed a range of leakages between 0 L/min and 5.5 L/min. The results showed that leakage performance varied widely between trocars and instruments and that the performance and location of the valves influenced trocar leakage. CONCLUSIONS: leakage for all new trocars and instruments is needed so surgical teams can avoid this potential health hazard when selecting new equipment.