隨著現代醫學技術的發展,微創外科手術在臨床上廣泛開展,而腹腔鏡外科技術是外科微創化的重要組成部分。清晰的手術視野是腹腔鏡手術的關鍵,因此腔鏡鏡頭的防霧處理關重要。在進行腔鏡手術過程中,由于體腔溫度和體外溫度相差較大,部分水蒸氣遇到冷的腔鏡鏡頭后容易凝聚形成一層霧,從而影響術野呈現在顯示器上的清晰度,影響手術操作。多年來,臨床采用傳統鏡頭預熱方法進行防霧處理,但該方法在實際應用中,經常會發生熱鹽水撒出、燙傷、鏡頭倒翻等現象,增加了術中污染和鏡頭損壞的幾率。
With the development of modern medical technology, minimally invasive surgery is widely carried out in clinic, and laparoscopic surgery is an important part of minimally invasive surgery. Clear surgical field of vision is the key to the safety of laparoscopic surgery, so the anti fog treatment of endoscopic lens is very important. In the process of endoscopic surgery, due to the large difference between the body cavity temperature and the external temperature, some of the water vapor is easy to condense and form a layer of fog after encountering the cold endoscopic lens, thus affecting the clarity of the surgical field on the display and the operation. For many years, the traditional lens preheating method has been used to prevent fogging in clinic, but in practical application, hot salt water is often spilled, scalded and lens overturned, which increases the probability of intraoperative pollution and lens damage.
鏡頭總是模糊不清,反復擦拭鏡頭,將會浪費大量時間,也會帶來不因素。這就要求扶鏡手要善于快速處理鏡頭起霧及污染問題,盡可能長久的保持視野的清晰,接下來就由
內窺鏡維修公司給大家分享一下方法。
The lens is always blurry. Repeatedly wiping the lens will waste a lot of time and bring unsafe factors. This requires that the hand holding the mirror should be good at dealing with the problem of lens fogging and pollution quickly, and keep the vision clear for as long as possible. Next, the endoscope maintenance company will share the solutions.
鏡頭起霧和污染的方法主要有:
The main solutions to fog and pollution of lens are as follows:
(1)購置帶鏡頭自加熱的腔鏡設備,但大部分無此功能;
(1) Purchase the cavity mirror equipment with lens self heating, but most brands do not have this function;
(2)鏡頭涂抹防霧劑,貴、成本高;
(2) Lens coating antifogging agent, expensive, high cost;
(3)碘伏紗布擦拭,成本較低,視野易發黃;
(3) Iodophor gauze wipe, low cost, easy to yellow vision;
(4)將鏡頭回縮 Trocar內,利用鏡頭 Trocar 內注入的相對低溫的 CO2 氣流使視野變清晰,但易反復;
(4) The lens is retracted into trocar, and the field of vision is clear by the relatively low temperature CO2 air flow injected into trocar, but it is easy to repeat;
(5)保溫杯裝熱水浸泡鏡頭,水溫保持在60 ~ 70℃,開始浸泡鏡頭時間要稍長,約 1 分鐘,好讓鏡頭充分預熱,高于腹腔內溫度。此后,每次鏡頭模糊后浸泡時間僅需幾秒即可。此法過程較為繁瑣。
(5) The lens shall be soaked in hot water in a sterilized heat preservation cup. The water temperature shall be kept at 60-70 ℃, and the lens shall be soaked for a little longer time, about 1 minute, so as to fully preheat the lens, which is higher than the temperature in the abdominal cavity. After that, it only takes a few seconds to soak the lens after each blur. The process of this method is complicated.
另外每次置入鏡頭前需將的密封墊內的組織或血液清理干凈,可以通過旋轉鏡身來避開 Trocar下端的血液;進出動作要迅速,避免鏡身在體外太久而降溫。
In addition, the tissue or blood in the gasket should be cleaned before each lens is put into the lens, and the blood at the lower end of trocar can be avoided by rotating the mirror body; the movement in and out should be rapid, so as to prevent the mirror body from cooling for too long in vitro.
當急性大出血污染鏡頭時,切不可拔出鏡頭擦拭,這樣可能會錯失處理的好時機,此時可以借助臟器漿膜面(多選擇未被污染的胃、腸漿膜面)快速而輕柔地擦拭鏡頭。不要選擇系膜或網膜表面,可能使鏡頭沾染油脂而更加模糊;也不要選擇肝臟或脾臟這類實質性臟器,防止損傷。當術者出血后,扶鏡手應重新擦拭鏡頭。
When the lens is polluted by acute massive hemorrhage, the lens must not be pulled out for wiping, which may miss the good opportunity of treatment. At this time, the lens can be wiped quickly and gently with the help of the visceral serous surface (mostly the unpolluted gastric and intestinal serous surface). Do not choose the surface of the mesentery or omentum, which may make the lens stained with grease and more fuzzy; do not choose the liver or spleen, which is a kind of substantive organ, to prevent damage. When the surgeon solves the bleeding, the lens should be wiped again by the hand holding the mirror.
為使手術進程自然順暢,扶鏡手應盡可能少的擦拭鏡頭。這就需要扶鏡手時刻做好對鏡頭的保護。比如在能量平臺刀頭燒灼組織時應將鏡頭適當退回規避調為遠距,防止組織液或血液飛濺污染鏡頭,待燒灼完成適時調回原來視距。
In order to make the operation process natural and smooth, the hand holding the mirror should wipe the lens as little as possible. This requires the hand holding the mirror to protect the lens at all times. For example, when the knife head of the energy platform burns tissue, the lens should be properly returned to avoid being adjusted to a long distance to prevent tissue fluid or blood splashing from polluting the lens. When the burning is completed, the original sight distance should be adjusted in time.
扶鏡手的任務是為手術者提供清晰穩定的手術圖像。且隨著手術進程變化,提供遠近范圍和角度適當的視野。也就是說,扶鏡手充當的是術者“雙眼”的作用。這就要求扶鏡手要對手術過程步驟及術者的手術習慣爛熟于胸,要跟手術者保持足夠的默契。
The task of the hand holding the mirror is to provide the surgeons with clear and stable surgical images. With the change of the operation process, it can provide a proper field of vision. In other words, the hand holding the mirror acts as the "eyes" of the performer. This requires that the hand holding the mirror should be familiar with the operation procedure and the operation habit of the operator, and keep enough tacit understanding with the operator.
The above is about the solution to the fog pollution of the endoscope lens. If you want to know more about the endoscope, please consult the official website of the endoscope maintenance company http://www.yojeim.com 。