Abstract
Abstract
Bad vision due to a dirty camera lens is one of the disadvantages and one of the most prominent frustrations in performing endoscopic surgery. Different methods to prevent lens fogging have been described; however, little is published about the prevention of lens contamination due to a dirty port. The authors report three port-cleaning methods: (1) sterile gauze wrapped around an endoscopic dissecting clamp, (2) sterile gauze wrapped around a Pean clamp, and (3) a 10-mm sterile cotton swab, all being simple, adequate, cost-saving solutions.
Introduction
Methods
During the endoscopic procedure, different port sizes are used; here we focus on the 10–12-mm ports that are usually used as camera port during laparoscopic operations. The first method for port cleaning is by sterile gauze tightly wrapped around an endoscopic dissecting clamp, the second technique is a sterile gauze tightly wrapped around a Pean clamp, and the third method is a 10-mm sterile cotton swab (Fig. 1). All methods can be reused during the procedure by moving them in and out of the port multiple times as shown.
Three different port-cleaning techniques.
Results
Method 1 is easy to construct and use. It cleans the entire trocar including the port; however, its disadvantage is the length. Because of the length of the endoscopic clamp, it is prone for falling off the table or needs to be presented by the OR nurse; in other words, it is not within direct range. The cleaning by the second method focuses on the seal of the port rather than the tip. As the port is most prone for contamination of the lens, it is usually sufficient. The true benefit of this method is its small size; the Pean clamp can be held in range of the surgeon (on top of the patient), which makes it time efficient as well. The third and final method cleans the whole port including the seal but is more at risk for loss in the abdomen; it also needs to be presented by the OR nurse because of the risk of falling off the table. Cleaning the camera port with one of the three techniques described above reduces lens contamination due to a dirty port. All techniques can be reused during the operation and are low in cost.
Discussion
Our experience is that the prevention of a lens contamination due to a dirty port largely improves when using one of the methods described in this article. Camera-port cleaning during endoscopic procedures is a simple and economic solution to this everyday problem. Our experience with technique No. 2, sterile gauze wrapped around a Pean clamp, has the preference above the other two, as the clamp can be held in close range of the surgeon and does not fall off the table. Alhamdani and colleagues reported the cleaning with culture swabs for the 5-mm trocar almost similar to technique No. 3. 3 Combining one of these techniques with the anticondensation technique1,2 will reduce annoyance even more.
Footnotes
Disclosure Statement
No competing financial interests exist.