A new device for the detection and recognition of blood vessels in laparoscopic surgery.
BACKGROUND
The recognition and localization of blood vessels to prevent their intraoperative perforation poses a major problem in laparoscopic surgery. The endoscopic pulse detector is a new device that has been specially developed for the detection and recognition of blood vessels in laparoscopic surgery. The instrument uses an accelerometer to detect a pulse, and it is inexpensive and simple to use. The aim of this study was to investigate the performance and possibilities of the new instrument.


METHODS
The instrument's performance and features were tested in laboratory conditions by use of simulated circulation. We assessed the dependence of the signal amplitude recorded by the instrument over a given blood vessel on the blood pump frequency change (36-130/min), circulating systolic pressure change (40-180 mm Hg), and adjacent blood vessel pulsations. Clinically, the instrument was tested in a randomized study in 40 elective noncomplicated laparoscopic cholecystectomies, where we assessed the time needed for the preparation of Calot's triangle and positioning of the cystic artery.


RESULTS
The results of laboratory testing showed that the instrument operated throughout the frequency range of 36-130/min and a circulating systolic pressure range of 40-180 mmHg, while the signal amplitude rose with pressure increase. The results of clinical testing showed that use of the pulse detector in laparoscopic cholecystectomy significantly reduced the time needed to prepare Calot's triangle (t = 3.91; df = 38; p <0.001) and also made the positioning of the cystic artery more reliable.


CONCLUSIONS
The study showed the new instrument to be very simple to use and potentially valuable in laparoscopic surgery, primarily for the differentiation of blood vessels of similar structures.
Glavić
Z
Z
General County Hospital, Osjećka bb, HR-34000 Pozega, Croatia. zeljko.glavic@bol-pozega.hinet.hr
Begić
L
L
Rozman
R
R
D001158:Arteries / Q000503:physiopathology*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002763:Cholecystectomy / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D011674:Pulse; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted