title: Electrostatic precipitation is a novel way of maintaining visual field clarity during laparoscopic surgery: a prospective double-blind randomized controlled pilot study.
abstract: BACKGROUND
  Ultravision™ is a new device that utilizes electrostatic precipitation to clear surgical smoke. The aim was to evaluate its performance during laparoscopic cholecystectomy.
  
  
  METHODS
  Patients undergoing laparoscopic cholecystectomy were randomized into "active (device on)" or "control (device off)." Three operating surgeons scored the percentage effective visibility and three reviewers scored the percentage of the procedure where smoke was present. All assessors also used a 5-point scale (1 = imperceptible/excellent and 5 = very annoying/bad) to rate visual impairment. Secondary outcomes were the number of smoke-related pauses, camera cleaning, and pneumoperitoneum reductions. Mean results are presented with 95% confidence intervals (CI).
  
  
  RESULTS
  In 30 patients (active 13, control 17), the effective visibility was 89.2% (83.3-95.0) for active cases and 71.2% (65.7-76.7) for controls. The proportion of the procedure where smoke was present was 41.1% (33.8-48.3) for active cases and 61.5% (49.0-74.1) for controls. Operating surgeons rated the visual impairment as 2.2 (1.7-2.6) for active cases and 3.2 (2.8-3.5) for controls. Reviewers rated the visual impairment as 2.3 (2.0-2.5) for active cases and 3.2 (2.8-3.7) for controls. In the active group, 23% of procedures were paused to allow smoke clearance compared to 94% of control cases. Camera cleaning was not needed in 85% of active procedures and 35% of controls. The pneumoperitoneum was reduced in 0% of active cases and 88% of controls.
  
  
  CONCLUSIONS
  Ultravision™ improves visibility during laparoscopic surgery and reduces delays in surgery for smoke clearance and camera cleaning.
authors.affiliation: Welsh Institute for Minimal Access Therapy (WIMAT), Cardiff, CF14 4UJ, Wales, UK, ansellj@cardiff.ac.uk.
authors.forename: James
authors.initials: J
authors.lastname: Ansell
authors.forename: Neil
authors.initials: N
authors.lastname: Warren
authors.forename: Pete
authors.initials: P
authors.lastname: Wall
authors.forename: Kim
authors.initials: K
authors.lastname: Cocks
authors.forename: Stuart
authors.initials: S
authors.lastname: Goddard
authors.forename: Richard
authors.initials: R
authors.lastname: Whiston
authors.forename: Michael
authors.initials: M
authors.lastname: Stechman
authors.forename: David
authors.initials: D
authors.lastname: Scott-Coombes
authors.forename: Jared
authors.initials: J
authors.lastname: Torkington
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation* / Q000379:methods*; D004311:Double-Blind Method; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D061646:Operative Time; D010865:Pilot Projects; D011446:Prospective Studies; D012906:Smoke; D055672:Static Electricity; D014785:Vision, Ocular
chemical_list: D000395:Air Pollutants, Occupational; D012906:Smoke