Distribution of surgical smoke particles within a simulated laparoscopic cavity utilizing an AirSeal® system.

An exploratory study was performed to determine the distribution of surgical smoke particulate matter (SSPM) and evacuation times within an AirSeal® System and a traditional insufflation access system in various simulated surgical scenarios. Identified trends showed statistical significance when setting the AirSeal® System to Low smoke evacuation that it reduces the percentage of particulate matter at the Access Port opening. Additionally, it was observed that when utilising a laparoscopic tool a similar trend in particle distributions were seen between either insufflation and access system at the opening of the Access Port and trocar. Evacuation times for SSPM removal within the AirSeal® System showed an overall average to ≥95% reduction of 5.64 min within the surgical cavity, 3.69 min at the Access Port opening, and 3.61 min within the smoke evacuation line. The overall average for the traditional insufflation and access system was 9.38 min within the surgical cavity and 6.06 min at the trocar opening. Results showed that when using the traditional system compared to the AirSeal® System, it resulted in a percent change increase in evacuation times of 66.31% within the surgical cavity and 64.23% at the trocar opening.

Clinical outcomes of low-pressure pneumoperitoneum in minimally invasive urological surgery.

The adoption of minimally invasive laparoscopic techniques has revolutionised urological practice. This necessitates a pneumoperitoneum (PNP) and the impact the PNP pressure has on post-operative outcomes is uncertain. During the current COVID-19 era guidance has suggested the utilisation of lower PNP pressures to mitigate the risk of intra-operative viral transmission. Review the current literature regarding the impact of pneumoperitoneum pressure, within the field of urology, on post-operative outcomes. A search of the PubMed, Medline and EMBASE databases was undertaken to identify studies that met the inclusion criteria. The Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines were adhered to. Ten studies, that included both randomised controlled trials and retrospective case series reviews, were identified that met the inclusion criteria. The effect of PNP pressure on outcomes following prostatectomy, live donor nephrectomy, partial nephrectomy and a variety of benign upper tract procedures were discussed. Low pressure PNP appears safe when compared to high pressure PNP, potentially reducing post-operative pain and rates of ileus. When compared to general surgery, there is a lack of quality evidence investigating the impact of PNP pressures on outcomes within urology. Low pressure PNP appears non-inferior to high pressure PNP. More research is required to validate this finding, particularly post-cystectomy and nephrectomy.

Staggered Nitinol Wire Actuator Array for High Linear Displacement and Force-to-Mass Ratio.

We present the design and performance of a unique Nitinol (NiTi) actuator design for high linear displacement and force generation through joule heating. The device is comprised of a staggered linear array of NiTi in wire form that, as a shape memory alloy, can achieve linear displacement through material phase change when heated. This change allows the crystal lattice within the material to displace/adjust. The design results in strain levels of 20.4% that are comparable to those of biological muscles and provides potential for additional strain. Three- to seven-staggered NiTi wires are tested to demonstrate the different levels of strain that are achieved with a range of wires in a staggered array. In addition, we measure and compare force generated to the mass of each wire to show system force-to-mass ratio. The effective force to mass for the system is greater than 5500 combined with a seven-wire staggered array. The device shows that a lightweight, high-strain actuator can be developed, and our research demonstrates its potential use in prosthetic actuation.