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首页> 外文期刊>Journal of pediatric urology >Reduction in surgical fog with a warm humidified gas management protocol significantly shortens procedure time in pediatric robot-assisted laparoscopic procedures
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Reduction in surgical fog with a warm humidified gas management protocol significantly shortens procedure time in pediatric robot-assisted laparoscopic procedures

机译：具有温暖的加湿气体管理方案的手术雾的减少显着缩短了儿科机器人辅助腹腔镜程序的过程时间

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Summary Introduction The adoption of robot-assisted laparoscopic (RAL) procedures in the field of urology has occurred rapidly, but is, to date, without pediatric-specific instrumentation. Surgical fog is a significant barrier to safe and efficient laparoscopy. This appears to be a significant challenge when adapting three-dimensional 8.5-mm scopes to use in pediatric RAL surgery. The objective of the present study was to compare matched controls from a prospectively collected database to procedures that were performed utilizing special equipment and a protocol to minimize surgical fog in pediatric RAL procedures. Methods A prospectively collected database of all patients who underwent RAL pediatric urology procedures was used to compare: procedure, age, sex, American Society of Anesthesiologists score, weight, console time, number of times the camera was removed to clean the lens during a procedure, length of hospital stay, and morphine equivalents required in the postoperative period. A uniquely developed protocol was used, it consisted of humidified (95% relative humidity) and warmed CO 2 gas (95?°F) insufflation via Insuflow? on a working trocar, with active smoke evacuation via PneuVIEW?XE on the opposite working trocar with a gas pass through of 3.5–5 l/min. The outcomes were compared with matched controls (Summary Fig). Results The novel gas protocol was utilized in 13 procedures (five pyeloplasties, two revision pyeloplasties, three ureteroureterostomies (UU), three nephrectomies) and compared with 13 procedures (six pyeloplasties, one revision pyeloplasty, three UU, three nephrectomies) prior to the protocol development. There was no statistical difference in age ( P ?=?0.78), sex ( P ?=?0.11), ASA score ( P ?=?1.00) or weight ( P ?=?0.69). There were no open conversions, ≥Grade 2 Clavien complications, or readmissions within 30 days in either group. Conclusions This novel gas protocol yielded a statistically significant reduction in procedure time, by decreasing the number of times the camera was required to be pulled during the case by more than five occurrences, and saved approximately 35?min on average per case. Display Omitted
机译：发明内容泌尿外科领域的机器人辅助腹腔镜（RAL）程序的采用迅速发生，但迄今为止，没有儿科特定仪器​​。外科雾是安全高效的腹腔镜检查的重要障碍。当适应小儿RAL手术时使用三维8.5毫米范围时，这似乎是一个重大挑战。本研究的目的是将匹配的控制与预期收集的数据库与采用特殊设备和协议进行的程序进行比较，以最大限度地减少儿科RAL程序中的手术雾。方法采用预期收集的所有患者的患者，均经过RAL儿科泌尿外科手术的患者进行比较：程序，年龄，性别，美国麻醉学家社会得分，重量，控制台时间，摄像机被移除的次数，在过程中清洁镜头术后期间所需的医院住宿长度，以及所需的吗啡等同物。使用唯一开发的方案，它由加湿（95％相对湿度）和温热的CO 2气体（95°F）通过Insuflow吹入（95°F）组成？在工作套管轨道上，通过Pneuview的积极烟雾疏散，在相对的工作套管针上，气体通过3.5-5升/分钟。将结果与匹配的对照进行比较（概要图）。结果新型天然气方案有13例（五个拍育叶，两种修订斑胨，三次输尿管术（UU），三个肾切除术），并在协议之前与13个程序（六个Pyeloplasties，三种修订Pyeloplasty，三种UU，三个肾切除术）进行比较发展。年龄没有统计学差异（p？= 0.78），性别（p？= 0.11），ASA得分（P？=？1.00）或重量（p？= 0.69）。没有开放的转换，≥在任一组内30天内的2克拉维恩并发症或入院。结论这种新型气体协议在案例中减少了速度下降了速度下降了统计上显着的减少，通过减少了在案件期间需要拉动的次数超过五次出现，平均每种情况下节省大约35个？最小。显示省略

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