back into the
abdomen. That
process removes par-
ticles that may inhibit
the surgeon's view
while also keeping the
gas warm and humid.
He's also an advocate
of the many devices
that preheat or pre-humidify insufflation gas before it enters the
abdomen, although in his experience the gas is never quite warm
enough or humid enough to combat lens fogging.
Another way to prevent lens fogging is to pre-warm the laparoscope
or rub an anti-fog solution on the camera lens (similar to what swim-
mers or skiers put on goggles to maintain clear views of the action).
In addition to coating lenses with an anti-fogging solution, Dr.
Oleynikov warms his laparoscopes before use to reduce condensation
on the lens that occurs when cold scopes are placed into warm
abdominal cavities. He uses an electronic scope warmer, but says
there are many ways to warm scopes, including bathing them in
warmed saline solution.
He says a device that sends a high-flow of CO
2
across the tip of the
scope to keep particles from sticking to the surface is helpful, but not
always reliable. "It's a great gizmo, and when it works, it works great,"
he says. "But it's expensive, and in my experience, requires more effort
than the benefit you derive from it."
3. Clean the lens. Removing and wiping down scopes several
times during a case is a sure-fire way to clean the lens, but it can
waste valuable OR time. Depending on the procedure , you may have
to clean the scope every 2 to 3 minutes, says Dr. Oleynikov.
Trocars designed to clean laparoscopic lenses as they're passed
1 1 4
O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2 0 1 5
Pamela
Bevelhymer,
RN,
BSN
z MODERATE TEMPERATURE Warming laparo-
scopes before procedures limits fogging of the lens.
