Physical principles adapted to clinical practice for a theoretical smoke evacuation device in laparoscopic surgery

Abstract

Suboptimal visualization of the surgical field due to smoke generated in any laparoscopic technique, along with the impact on healthcare workers exposed to its toxic particles, has prompted the marketing of various suctioning devices. A limited information on physical basis of these systems has encouraged us to develop a theoretical model that enables a basic experimental recreation of smoke evacuation in pneumoperitoneum. The cooling effect of the abdominal cavity due to the circulation of insufflated gas and variations in its composition resulting from the operative use of electrocoagulation are the primary factors that lead to the collapse of a circuit designed under laminar flow conditions when an increase in suction flow rate is required to preserve surgical vision. The pressure difference generated in the circuit by tripling its flow induces a change in flow regime, preventing collapse without the need for excessive gas renewal. An analysis of the cross-sectional radius, tube wall composition and absolute roughness of endoluminal surface are conducted to assess performance of our model. Behavior of fluids in different pathophysiological situations is studied by Science undergraduates, but instructional simulations in the laboratory often fail to transfer this knowledge into the design of practical devices that correlate the statics of an inert material with the variability of a biological system. This theoretical device has been crafted to encourage students interested in the experimental patterns for biomedical applications related to fluid behavior and turnover during minimally invasive procedures involving the peritoneal cavity.