Laparoscopic Visualization vs. Surgical Safety
At ClearCam, we make a “windshield wiper for laparoscopes.” As such, visualization for surgeons is a primary focus for us, if not THE primary focus, for our company.
And we get it – we aren’t curing cancer. You won’t hear us claim to do that, ever.
What we do claim to do is tackle the most common and frustrating event that happens during laparoscopic surgery. We allow clinicians to intraoperatively clean their laparoscope lens quickly and effectively, mitigating interruption of surgical workflow. This gives us the ability to create some interesting impact in the operating room. Some of which includes:
Mitigating more than 90% of scope removals for lens cleaning *1
Saving some operating time, especially compared to the gold standard ex-vivo cleaners (e.g., technologies used to clean the lens outside the body) - on average, 7% of laparoscopic surgical time is spent cleaning the scope, and a combined 44% is spent with sub-optimal or obscured visualization *2
Reducing frustration and surgical interruptions *1
Improving safety in the operating room *1
That last one – improving safety – is something that not many people realize is directly linked with surgical visualization (that primary focus for ClearCam that I mentioned earlier). My favorite part of this conversation is letting the published and peer-reviewed data speak for itself:
Longer surgical times are shown to link to higher rates of surgical site infections and complications *3
Instrument exchange through trocar ports, such as when removing the scope for lens cleaning, increases potential exposure events of OR personnel to aerosolized contaminants like HPV and carcinogens – brought back into the spotlight from recent years given the concern around the potential spread of COVID-19 in the same manner. *4,5
Surgical interruptions related to equipment problems actually represent the highest risk of impact on procedures and are shown to decrease OR quality and safety. *6
Noting the above facts (not to mention the extensive wealth of medical literature not referenced), it is now unsurprising to discover that data shows nearly 1 out of every 5 surgical injuries are linked to poor visualization. Injuries can range from vessel injury, intraoperative bleeding/blood loss, and even cause the conversion of the case from laparoscopic to open. *7,8
As I said, we know we are not curing cancer. But we are solving a real problem, with a real solution, to generate real impact. Sometimes cleaning the scope can be a minor annoyance, sometimes a major pain, and sometimes it can lead to catastrophic events. As CTO of ClearCam I can tell you we are here for all of it, and we have set our sights on improving our impact on visualization and other surgical problems in the future.
Reach out if you ever want to learn more about what we do here.
Chris Idelson, PhD
Cofounder and CTO
ClearCam – Surgery as it’s meant to be seen
References:
Data on file
Yong, N. et al., D. (2016). Impact of Laparoscopic Lens Contamination in Operating Theaters: A Study on the Frequency and Duration of Lens Contamination and Commonly Utilized Techniques to Maintain Clear Vision. Surgical laparoscopy, endoscopy & percutaneous techniques, 26(4), 286–289.
F. Pryor, P.R. Messmer, " The Effect of Traffic Patterns in the OR on Surgical Site Infections," AORN Journal vol. 68 no.4, pp. 649-660, 1998
Robertson, D., Sterke, F., van Weteringen, W., Arezzo, A., Mintz, Y., Nickel, F., Boni, L., Baldari, L., Carus, T., Chand, M., Fuchs, H., Ficuciello, F., Marconi, S., Mylonas, G., Kim, Y. W., Nakajima, K., Schijven, M., Valdastri, P., Sagiv, C., Mascagni, P., Myśliwiec, P., Petz, W., Sánchez-Margallo, F., and Horseman, T., 2021, “Characterisation of Trocar Associated Gas Leaks during Laparoscopic Surgery,” Surg. Endosc.
Hensman, C., Baty, D., Willis, R. G., and Cuschieri, A., 1998, “Chemical Composition of Smoke Produced by High-Frequency Electrosurgery in a Closed Gaseous Environment. An in Vitro Study,” Surg. Endosc., 12(8), pp. 1017–1019.
D. A. Wiegmann, A. W. ElBardissi, J. A. Dearani, R. C. Daly, and T. M. Sundt, “Disruptions in surgical flow and their relationship to surgical errors: An exploratory investigation,” Surgery, vol. 142, no. 5, pp. 658–665, Nov. 2007.
E. M. Bonrath, L. E. Gordon, and T. P. Grantcharov, “Characterising ‘near miss’ events in complex laparoscopic surgery through video analysis,” BMJ Qual. Saf., vol. 24, pp. 516–521, 2015.
D. Dindo, M. Schafer, M. K. Muller, P. A. Clavien, and D. Hahnloser, “Laparoscopy for small bowel obstruction: The reason for conversion matters,” Surg. Endosc., vol. 24, no. 4, pp. 792–797, Sep. 2010
