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valuable minutes as he repeatedly removes the scope for cleaning or constantly
pauses to ventilate the surgical site. Thankfully, there are ways to ensure your
surgeons maintain clear views of the action.
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Eliminate the smoke
The smoke that's generated by electrocautery, laser tissue ablation or
ultrasonic scalpel dissection in the close confines of the pneumoperi-
toneum can also impair the laparoscopic surgeon's view of the surgical site.
Even high-definition scopes and widescreen monitors offer little benefit when a
smoke-filled cavity casts a haze over the image, flattening depth perception and
dulling color differentiation. "It is critically important to keep the field smokefree," says Robert Baxt, MD, a laparoscopic hernia repair and abdominal wall
reconstruction specialist based in Avon, Conn. "This explains the growing popularity of smoke evacuators in the OR."
In addition to the units and accessories that suction smoke away from open
or skin-level sites, devices are available to clear the air inside the peritoneum by
way of the trocars your surgeons are working through. "A passive, automatic
smoke filter that continuously
ventilates and filters the
smoke doesn't require the
surgeon to stop what he's
doing, which is a big benefit,"
says William L. Barrett, MD,
of CaroMont Surgical
Associates in Gastonia, N.C.
If trocar ports are at a premi-
DOWN THE TUBES Insufflation and smoke
evacuation play complementary roles.
um, the evacuation devices
can be inserted and removed as needed.
A smoke evacuator's suction capacity and filtration quality are major considerations in evaluating its effectiveness. But whether it's inobtrusive to a surgeon's technique, easy for surgical staff to set up and adjust, and acceptably
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