Research and Data
Laparoscopic Surgery
A Clean Sweep: Initial Experience with a Novel Intracavity Laparoscopic Cleaning Device
The Novel Intracavitary Laparoscopic Cleaning Device (NILCD) efficiently cleaned laparoscopic lenses during surgery without removal, achieving a 90.14% success rate in preventing scope removal during debris events in 167 cases across various surgical specialties, demonstrating its robust effectiveness and positive surgeon satisfaction across a wide range of surgical procedures and scenarios.
Blurred vision, clear concern: linking poor visualization with adverse events in minimally invasive surgery
Researchers found that 72% of visualization-related reports were linked to patient injury, with certain visualization problems (e.g., occlusion, blur, impaired view) showing injury rates over 90%. While robotic surgeries generated fewer reports overall, a higher proportion involved patient harm compared to traditional laparoscopy. Given the likelihood of significant underreporting, the authors estimate that visualization issues could affect over 120,000 patients annually. The study concludes that suboptimal visualization is strongly tied to adverse outcomes, underscoring the urgent need for improved technology, reporting, and standards of care in MIS.
Design and Performance Testing of a Novel In Vivo Laparoscope Cleaning Device
This study describes the design and benchtop testing of a novel in vivo laparoscope lens cleaning device intended to eliminate the need for repeated scope removal during surgery. Using a simulated surgical environment, the device effectively cleared condensation, blood, and fat from laparoscope lenses with performance comparable to or exceeding current gold-standard methods. Mechanical testing showed strong durability and resistance to failure, suggesting reliable safety even under potential misuse. By enabling rapid in vivo cleaning, the device has the potential to reduce operative time, improve workflow efficiency, and enhance patient safety in laparoscopic surgery.
Translation of Laparoscopic Surgical Innovation: Discovering and Deciphering Practices and Policy Impacts
Based on over 100 interviews with healthcare professionals, this study found that the adoption of new laparoscopic technologies is primarily determined by cost, its effect on the standard of care, and existing policies. The research revealed that smaller companies face more significant challenges than larger entities when navigating commercial factors, regulatory requirements, intellectual property, and manufacturing. A primary clinical need identified by surgeons was obscured vision from lens debris, a problem not specifically addressed by current standards. Ultimately, these factors create an uneven playing field that can hinder innovation and limit patient access to new surgical technologies.
Stop the leak!: Mitigating potential exposure of aerosolized COVID-19 during laparoscopic surgery
Investigating gas leakage during laparoscopic surgery, researchers found consistent and notable leakage during instrument exchanges in and out of trocar ports. Data shows an increased level of potential exposure events for healthcare professionals to aerosolized particles, including viruses, during such instrument exchanges (i.e., scope removals for lens cleaning). Minimizing laparoscope and instrument replacement is crucial for safety of the OR team, as was noted most especially during the COVID-19 pandemic.
Clear Vision, Clear Savings: Enhancing Efficiency in Minimally Invasive Surgery
This review shows that poor visualization in minimally invasive surgery (MIS)—from lens fogging, debris, or camera issues—leads to surgeons operating with impaired vision up to 40% of the time and contributes to about 20% of complications. The added costs, from scope cleaning and visualization-related issues, exceed $1.1 billion annually in the U.S. Beyond financial impact, suboptimal vision disrupts workflow, increases surgeon fatigue, and limits adoption of advanced technologies like AI that rely on clear imaging. The authors call for better protocols, training, and new technologies to improve surgical safety and efficiency.
Validation of a Novel “Windshield Wiper” for Laparoscopes in Cadaver and Live Porcine Models
This study validated a novel in vivo laparoscope “windshield wiper” cleaning device through cadaveric and live porcine models. In cadaver studies, the device achieved significantly faster cleaning (5 ± 5 s vs. 14–16 s with gold-standard technologies) and eliminated scope removals entirely (0 vs. 102–116 removals). In live animal testing, it reliably cleared fog, blood, bile, and tissue debris within the warm-body environment. Surgeons rated it highest for cleaning efficiency, usability, and workflow value. The findings suggest this device could reduce surgical interruptions, improve visualization, and enhance safety in laparoscopic procedures compared to existing methods.
Robotic Surgery
Impaired robotic surgical visualization: archaic issues in a modern operating room
Robotic-assisted surgery faces challenges in visualization, with over half of observation time compromised by lens occlusions, attributed to a variety of surgical factors and activities. A staggering 20% of surgeries may have 90% of the time spent under suboptimal visualization! Addressing these issues is crucial for improving the effectiveness and safety of procedures.
Assessing visualization in robotic-assisted surgery: demystifying a misty lens
In Da Vinci XI robotic-assisted surgery, frequent lens occlusion events occur every 24.5 minutes, despite cleaning every 36.5 minutes. Surgeons worked through compromised visualization for nearly 35x the time it would take to clear the lens. Surgeon reluctance to interrupt procedures for maintenance prompts further investigation into its impact on outcomes and patient safety.