• Yung-Chien Chou, Tzu-Chia Tung, Patricia Wanping Wu, Been-Ren Lin, and Shuo-Lun Lai.
• Department of Mechatronics Engineering, National Changhua University of Education, Changhua, 50074, Taiwan.
• J Formos Med Assoc. 2024 Dec 20.

BackgroundSurgical smoke generated by energy devices poses health risks to medical staff. During laparoscopic surgery, the smoke aggregating around the camera obstructs the visual field, forcing surgeons to interrupt surgery, and may increase surgical risk. We propose a proximal smoke evacuation method to improve surgical quality by effectively eliminating surgical smoke.MethodsA smoke evacuation device was designed to attach to a laparoscopic electrode and create a channel for smoke to be suctioned directly from near the tip of the electrode (proximal evacuation). An animal study was conducted to collect videos of electrocautery with proximal (device) evacuation, distal (trocar) evacuation, and no evacuation. We used a computer vision-based model to compare in-screen smoke density and image quality between different evacuation pathways.ResultsCompared with distal and no evacuation, proximal evacuation had significantly lower estimated in-screen smoke density and higher image quality (p < 0.001). The pneumoperitoneum pressure remained above 8 mmHg throughout the procedure with proper suction pressure setting. A total of 62 trials performed by 15 surgeons produced consistent results, supporting the core findings of this study. On average, proximal evacuation can eliminate 85.47% of the smoke around operative fields within 10 s.ConclusionsProximal smoke evacuation is capable of maintaining a clean surgical field and high image quality during laparoscopic surgery. The device can help avoid interrupting surgeries to wait for the smoke to clear or clean the camera lens.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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