(E-177) A Novel Lens Cleaning Device for Improved Laparoscopic/Endoscopic Visualization in Situ

Introduction:: Clear visual acuity is critical in laparoscopic procedures. However, many laparoscopic cameras require removal and cleaning multiple times during surgery due to bodily debris, fog, and fluid. This external cleaning process occupies valuable operation time and interferes with the surgeon's focus. Therefore, there is a need to increase the visual acuity of laparoscopic cameras during surgical procedures without removing the camera from the body cavity. A solution to this problem is hypothesized to reduce operation time, increase the efficiency of the operative workflow, and minimize surgical errors. The authors generated and evaluated a potential prototype for this clinical need.

Materials and Methods:: A thorough literature review was conducted to evaluate the topic, followed by stakeholder interviews to understand current clinical practice. Concept generation was then conducted to generate four potential solutions to our topic. After further evaluation of each concept’s risks and opportunities, prototyping was begun on one chosen concept. The design was created in computer-aided design (CAD) software and 3D printed to create a looks-like prototype. However, an ideal final device will be composed of metal and polyamide and be sterilizable. Next, a works-like prototype was developed using an Arduino Uno R3 board, a servo motor with a rubber attachment, and a 3D printer. Testing of the works-like prototype was conducted using a large-scale laparoscopic camera, and a visual assessment of debris clearance was analyzed.

Results, Conclusions, and Discussions:: Ten stakeholder interviews were conducted in a six-week period. Individuals interviewed included patients who have undergone laparoscopic/endoscopic operations, general surgeons, and gastroenterologists. The interviews confirmed that many physicians experienced frustration and decreased workflow efficiency due to having to remove a laparoscope for cleaning, especially when it needed to be done multiple times in a single operation. This confirmation led to the development of a tube-like device with a thin wiper blade that a laparoscope can be placed in. The code to program the device was written in Arduino IDE. With a simple button-style trigger, the wiper at the end of the device would remove any debris stuck to the lens. Upon developing a works-like prototype, testing was conducted by occluding the laparoscope with fog, water, wood chips, or a mix of water/wood chips. The works-like prototype successfully cleared a majority of the debris in each trial run, going from a blurry view to a clear one (Figure 1).



This in situ laparoscopic/endoscopic lens cleaning device can efficiently clear a laparoscope lens of bodily debris without requiring the removal of the entire device from the body cavity. As a result, surgeons are able to continue with their work without any interruptions. While not tested in this study, such a device may lead to decreased operating times, fewer patient complications, and reduced surgical interruptions. Next steps for this project include the development of a works-like/looks-like prototype that can be tested using animal tissue to simulate an in situ environment.



As surgical robotics become more advanced, more procedures are becoming less invasive and utilizing laparoscopes/endoscopes instead. With this trend occurring across many surgical specialties, maintaining clear vision with fewer interruptions will improve surgical efficiency and increase patient safety.


Acknowledgements (Optional): : We would like to thank the EnMed program for providing us with funding for materials and a space to conduct the project. We would also like to thank Dr. Nicholas Sears for his mentorship and guidance throughout.

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