Managing the flow
First-generation irrigation pumps relied solely on gravity to pump
fluid into joints. The flow of fluid wasn't well controlled and it didn't
distend joints very well, so the surgeon's view of the operative space
was limited. The next generation of pumps delivered fluid into the
joint, but surgeons had to manually regulate the flow and pull excess
fluid out with suction to ensure levels didn't get too high. The newest
"smart" pumps push and pull fluid into and out of the joint and auto-
matically adjust to attain an equilibrium at preset levels.
For example, a surgeon can set the pump to deliver 50 mmHg of irri-
gation fluid and focus on performing surgery in knowing the pump
will maintain that rate throughout the procedure. When surgeons suc-
tion fluid out of the joint, the pump automatically compensates by
increasing the amount of fluid that's delivered. Automatic pumps can
sense when distention pressure is dropping — when burrs and
shavers are in use, for example — and adjust accordingly. The con-
stant balance of fluid distends the joint, maintains a stable operative
space and improves the surgeon's visualization.
Automated irrigation pumps also help prevent "red out," which can be a
major issue during arthroscopic procedures performed in the hip, knee or
shoulder. During those joint procedures, surgeons work with delicate soft
tissue that contains small blood vessels. As they cut or debride the tissue,
blood can fill the joint and cause "red out" conditions in which they lose
all visualization. The latest irrigation pumps, which regulate the pressure
within the joint, automatically increase the flow of irrigation fluid to com-
pensate for the increasing levels of blood. That's extremely beneficial in
maintaining a surgeon's view of the joint space and has the potential to
make arthroscopic surgery more efficient.
The latest irrigation pumps can also make arthroscopic surgery
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