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Hafeza S, Firdaus S, Goh LC, Jeyanthi K. A Low-cost 3D Printed Telescopic Sleeve: A Technical Note. Indian J Otolaryngol Head Neck Surg 2023; 75:1259-1262. [PMID: 37275017 PMCID: PMC10235348 DOI: 10.1007/s12070-022-03281-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/13/2022] [Indexed: 12/14/2022] Open
Abstract
Background: Endoscopic nasal surgery is often a tedious process due to repeated removal of the Hopkins rod telescope from the nasal cavity for manual defogging of the tip due to the presence of blood, smoke, and secretions. Objective: To design and print a 3-dimensional (3D) low-cost telescopic sleeve to allow the defogging solution to clean the rigid telescope tip without removing it from the nasal cavity. In addition, the sleeve must also act as a conduit for suction and irrigation to provide a clear surgical field view intraoperatively. Results and conclusion: A 3D printed low-cost telescopic sleeve, when used in conjunction with other add-ons, can be a helpful and cost-effective adjunct during endoscopic nasal surgery. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03281-0.
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Affiliation(s)
- Salleh Hafeza
- Department of Otorhinolaryngology, Hospital Sultanah Aminah, Johor Bahru, Malaysia
- Department of Otorhinolaryngology, University of Malaya, Wilayah Persekutuan Kuala Lumpur, Jalan Profesor Diraja Ungku Aziz, 50603 Kuala Lumpur, Malaysia
| | - Shamsuddin Firdaus
- Department of Otorhinolaryngology, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - Liang Chye Goh
- Department of Otorhinolaryngology, University of Malaya, Wilayah Persekutuan Kuala Lumpur, Jalan Profesor Diraja Ungku Aziz, 50603 Kuala Lumpur, Malaysia
| | - Kulasegarah Jeyanthi
- Department of Otorhinolaryngology, University of Malaya, Wilayah Persekutuan Kuala Lumpur, Jalan Profesor Diraja Ungku Aziz, 50603 Kuala Lumpur, Malaysia
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Ravisankar NP, D'Silva CS, Varma MMKG, Sudarsan TI, Sampath S, Thomas T, Krishna B. Fogging of Protective Eyewear in Intensive Care Unit and a Comparative Study of Techniques to Reduce It. Indian J Crit Care Med 2023; 27:32-37. [PMID: 36756478 PMCID: PMC9886044 DOI: 10.5005/jp-journals-10071-24383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/18/2022] [Indexed: 01/02/2023] Open
Abstract
Background Fogging of protective eyewear (PEW) can hinder routine work in the intensive care unit (ICU). The prevalence of fogging impairing vision (FIV) and the technique that reduces fogging have not been evaluated previously. Methods After donning personal protective equipment (PPE) with an N95 mask, the healthcare workers (HCWs) sequentially tried plain PEW, soap-coated PEW, PEW worn at a distance over the PPE hood, and the use of tape over a mask. The vision (distant and near) was checked before wearing PEW and with each technique. The prevalence of fogging and FIV, that is, change in vision in either eye was estimated and compared among various techniques. Mixed-effects logistic regression was used to analyze factors affecting fogging and to compare techniques. Room temperature, room humidity, and lens temperature were measured during the study. Results A total of 125 HCWs participated (151 observations) and the prevalence of FIV was 66.7%. The fogging of PEW, as well as the extent of PEW fogging, was least with soap coating followed by a mask with tape and goggles worn at a distance. The FIV was significantly lesser only with the mask with tape with an odds ratio (OR) [confidence interval CI)] of 0.45 (0.25-0.82). The prevalence of fogging while at work in the COVID ICU was 38%. Conclusion The prevalence of FIV is 66%. Application of tape over the mask can avoid disturbances in vision best. Soap coating of the PEW and PEW worn at distance from the eyes are potential alternatives. How to cite this article Ravisankar NP, D'Silva CS, Varma MMKG, Sudarsan TI, Sampath S, Thomas T, et al. Fogging of Protective Eyewear in Intensive Care Unit and a Comparative Study of Techniques to Reduce It. Indian J Crit Care Med 2023;27(1):32-37.
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Affiliation(s)
- Natesh Prabu Ravisankar
- Department of Critical Care Medicine, St. John's Medical College Hospital, Bengaluru, Karnataka, India,Natesh Prabu Ravisankar, Department of Critical Care Medicine, St. John's Medical College Hospital, Bengaluru, Karnataka, India, Phone: +91 9969523803, e-mail:
| | - Carol Shayne D'Silva
- Department of Critical Care Medicine, St. John's Medical College Hospital, Bengaluru, Karnataka, India
| | | | - Thomas Isiah Sudarsan
- Department of Critical Care Medicine, Mazumdar Shaw Medical Center, Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka, India
| | - Sriram Sampath
- Department of Critical Care Medicine, St. John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Tinku Thomas
- Department of Biostatistics, St. John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Bhuvana Krishna
- Department of Critical Care Medicine, St. John's Medical College Hospital, Bengaluru, Karnataka, India
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Allegrini D, Raimondi R, Montericcio A, Ricciardelli G, Romano MR. Lens fogging comment on “Infection control measures in ophthalmology during the COVID-19 outbreak: A narrative review from an early experience in Italy”. Eur J Ophthalmol 2022; 32:NP318-NP319. [DOI: 10.1177/1120672120966567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Davide Allegrini
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Raffaele Raimondi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | | | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Pandey K, Vig S, Ratre B, Gupta N. Use of Sterillium on Protective Goggles for Anti-Fogging during Donning for Care of COVID-19 Patients: A Novel Technique. Turk J Anaesthesiol Reanim 2020; 48:344-345. [PMID: 32864655 PMCID: PMC7434339 DOI: 10.5152/tjar.2020.682] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/26/2020] [Indexed: 01/10/2023] Open
Affiliation(s)
- Khushboo Pandey
- Dr BRAIRCH, All India Institute of Medical Sciences, Onco-Anaesthesia and Palliative Medicine, New Delhi, India
| | - Saurabh Vig
- National Cancer Institute, All India Institute of Medical Sciences, Onco-Anaesthesia and Palliative Medicine, New Delhi, India
| | - Brajesh Ratre
- Dr BRAIRCH, All India Institute of Medical Sciences, Onco-Anaesthesia and Palliative Medicine, New Delhi, India
| | - Nishkarsh Gupta
- Dr BRAIRCH, All India Institute of Medical Sciences, Onco-Anaesthesia and Palliative Medicine, New Delhi, India
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Chainansamit S, Chit-Uea-Ophat C, Reechaipichitkul W, Piromchai P. The Diagnostic Value of Traditional Nasal Examination Tools in an Endoscopic Era. EAR, NOSE & THROAT JOURNAL 2019; 100:167-171. [PMID: 31547699 DOI: 10.1177/0145561319875711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND As the endoscope has become more common in the otolaryngologist's office, there is a need to reevaluate the value of traditional nasal examination methods. The objective of this study was to determine the sensitivity and specificity of traditional nasal examination tools compared to those of the rigid endoscope. METHODS A prospective diagnostic study was conducted. Eligible patients with nasal symptoms were recruited and examined using 4 tools: (1) a nasal speculum, (2) an otoscope, (3) a posterior rhinoscopy mirror, and (4) a rigid nasal endoscope. The diagnostic value of each tool was evaluated. RESULTS There were a total of 53 patients eligible for inclusion in the study. The mean age of all patients was 40.9 years. The most common nasal symptom was nasal obstruction (90.6%). With regard to the tools used in anterior rhinoscopy, the nasal speculum had a sensitivity of 54.69% (95% confidence interval [95% CI]: 41.75-67.18) and specificity of 88.10% (95% CI: 74.37-96.02); and the otoscope had a sensitivity of 57.81% (95% CI: 44.82-70.06) and specificity of 85.71% (95% CI: 71.46-94.57). After application of topical anesthesia and decongestant, the nasal speculum had a sensitivity of 67.19% (95% CI: 54.31-78.41) and specificity of 85.71% (95% CI: 71.46-94.57); and the otoscope had a sensitivity of 65.62% (95% CI: 52.70-77.05) and specificity of 83.33% (95% CI: 68.64-93.03). The posterior rhinoscopy mirror had a sensitivity of 12.50% (95% CI: 5.18-24.07) and specificity of 94.00% (95% CI: 83.45-98.75). All adverse events in this study were minor. CONCLUSION The traditional nasal examination tools exhibited excellent specificity. However, the sensitivity was only average, meaning that they may not be suitable for screening. We do not recommend routine use of topical anesthesia and decongestants when applying these tools, as the application of these agents did not improve the clinical sensitivity or specificity. The posterior rhinoscopy mirror had a lowest sensitivity. We thus do not recommend using a posterior rhinoscopy mirror to rule out pathologies of the posterior nasal cavity.
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Affiliation(s)
- Seksun Chainansamit
- Department of Otorhinolaryngology, 37690Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chonthicha Chit-Uea-Ophat
- Department of Otorhinolaryngology, 37690Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wisoot Reechaipichitkul
- Department of Otorhinolaryngology, 37690Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Patorn Piromchai
- Department of Otorhinolaryngology, 37690Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Water drop-surface interactions as the basis for the design of anti-fogging surfaces: Theory, practice, and applications trends. Adv Colloid Interface Sci 2019; 263:68-94. [PMID: 30521982 DOI: 10.1016/j.cis.2018.11.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/23/2018] [Accepted: 11/20/2018] [Indexed: 11/22/2022]
Abstract
Glass- and polymer-based materials have become essential in the fabrication of a multitude of elements, including eyeglasses, automobile windshields, bathroom mirrors, greenhouses, and food packages, which unfortunately mist up under typical operating conditions. Far from being an innocuous phenomenon, the formation of minute water drops on the surface is detrimental to their optical properties (e.g., light-transmitting capability) and, in many cases, results in esthetical, hygienic, and safety concerns. In this context, it is therefore not surprising that research in the field of fog-resistant surfaces is gaining in popularity, particularly in recent years, in view of the growing number of studies focusing on this topic. This review addresses the most relevant advances released thus far on anti-fogging surfaces, with a particular focus on coating deposition, surface micro/nanostructuring, and surface functionalization. A brief explanation of how surfaces fog up and the main issues of interest linked to fogging phenomenon, including common problems, anti-fogging strategies, and wetting states are first presented. Anti-fogging mechanisms are then discussed in terms of the morphology of water drops, continuing with a description of the main fabrication techniques toward anti-fogging property. This review concludes with the current and the future perspectives on the utility of anti-fogging surfaces for several applications and some remaining challenges in this field.
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Palvia V, Gonzalez AJH, Vigh RS, Anasti JN. A Randomized Controlled Trial Comparing Laparoscopic Lens Defogging Techniques through Simulation Model. Gynecol Minim Invasive Ther 2018; 7:156-160. [PMID: 30306034 PMCID: PMC6172873 DOI: 10.4103/gmit.gmit_39_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/14/2018] [Accepted: 07/17/2018] [Indexed: 11/04/2022] Open
Abstract
Context Current literature demonstrates a lack of comparative studies regarding effective techniques for reducing laparoscopic lens fogging. Aim Our primary objective is to determine the efficacy of various laparoscopic defogging techniques (LDT) through a randomized controlled trial that employs a novel simulation model of the abdominopelvic cavity. Settings and Design This study was conducted at academic community hospital. This study design was a randomized controlled trial through simulation. Subjects and Methods A chamber was constructed that simulated the abdominopelvic cavity. We used 5 and 10 mm 0° laparoscopes. A 10 cm visual analog scale was developed to assign visual clarity (VC) scores. The 10 cm mark indicated perfect VC. We employed the following LDTs: (1) glove warming (GLOVE), (2) surfactant solution (Fog Reduction and Elimination Device [FRED]), (3) chlorhexidine solution (SOAP), (4) warm saline (SALINE), and (5) control. Three observers were blinded to the LDT used. Primary outcomes included VC scores at designated time intervals (5, 30, and 60 s) for each LDT. A minimum of 10 observations per time interval were required to achieve adequate power based on a 2.5 cm difference in VC scores. Results For the 10 mm laparoscope, FRED, SOAP, and SALINE had a VC score at 60 s (VC60) higher than control (4.8 ± 2.2, 7.8 ± 0.8, 7.9 ± 0.7 vs. 2.4 ± 0.72, P < 0.05). Both SOAP and SALINE VC60 scores were higher than FRED (7.8 ± 0.8, 7.9 ± 0.7 vs. 4.8 ± 2.2, P < 0.05). No differences were noted in VC60 scores between control and GLOVE (2.4 ± 0.72 vs. 3.1 ± 2.2, P > 0.05) and between SOAP and SALINE (7.8 ± 0.8 vs. 7.9 ± 0.7, P > 0.05). Similar results were noted with the 5 mm laparoscope. Conclusions Common LDTs such as SALINE and SOAP were more effective than FRED, while GLOVE was no different than control. These results demonstrate that the use of effective LDTs can potentially translate into improved patient care and operative outcomes during surgery.
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Affiliation(s)
- Vijay Palvia
- Department of Obstetrics and Gynecology, St. Luke's University Health Network, Bethlehem, PA, USA
| | - Aaron J Herrera Gonzalez
- Department of Obstetrics and Gynecology, St. Luke's University Health Network, Bethlehem, PA, USA
| | - Richard S Vigh
- Department of Obstetrics and Gynecology, St. Luke's University Health Network, Bethlehem, PA, USA
| | - James N Anasti
- Department of Obstetrics and Gynecology, St. Luke's University Health Network, Bethlehem, PA, USA
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Abstract
Background and Objectives: Laparoscopic surgery can be complicated by condensation and debris on the lens obscuring the visual field, increasing the risk of surgical error and injury to the patient. Despite, development of possible solutions, little is known regarding the quantitative measure of time lost during surgery because of an obscured visual field. Without this knowledge, the cost of laparoscopic lens fogging cannot be quantified and compared to the cost of antifogging devices. In the present study, we investigated the amount of time a laparoscope is withdrawn for cleaning during surgery. Methods: This was a prospective, observational study of patients (n = 52) who underwent laparoscopic surgery at Florida Hospital Celebration Health. Patient's age, gender, and body mass index, operative time, wound class, estimated blood loss, type of procedure, and complication (if any) were collected. In addition, intraoperative information on the number of times and total amount of time the laparoscope was withdrawn because of obscured visual field were recorded. Results: Eighty-two percent (43) of the procedures required laparoscope withdrawal because of fogging. Increased operative time, increased blood loss, and patient age correlated with the number of times (P < .05) and amount of time (P < .05) the laparoscope was withdrawn. Discussion: There was a significant correlation between increased laparoscope withdrawal because of an obscured visual field with increased EBL, operative time, and patient age. Possible explanations include change in body composition with age, the increased viewing angles required for more complex procedures, and increasing intraoperative effect on the surgeon of the poor visual field caused by fogging and debris.
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Affiliation(s)
- Danielle Abbitt
- University of Central Florida College of Medicine, Department of Faculty and Academic Affairs, Orlando, Florida, USA
| | - Bertha Ben Khallouq
- University of Central Florida College of Medicine, Department of Faculty and Academic Affairs, Orlando, Florida, USA
| | - Jay Redan
- Medical Director of Minimally Invasive Surgery, Florida Hospital-Celebration Health Professor of Surgery, Voluntary Faculty, University of Central Florida College of Medicine
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Prospective, randomized comparison of the use of FloShield Air System ® versus the reference technique (water + povidone-iodine solution) during gynecologic endoscopic surgery to evaluate the operative lens vision quality. Surg Endosc 2017. [PMID: 28643058 DOI: 10.1007/s00464-017-5642-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The FloShield Air System® is a new device for laparoscopic surgery that utilizes a continuous dry CO2 gas flow over the scope to defog the lens and protect it from condensation, debris and smoke. We set out to compare the performance and efficiency of the device in terms of operative lens vision quality (OLVQ) with the reference technique (water + povidone-iodine (PVI) solution) during gynecologic laparoscopic surgery. MATERIALS AND METHODS We conducted a single-center randomized prospective study between March and June 2016 (Trials Database Registration NCT02702531) including 53 patients undergoing gynecologic laparoscopic surgery with water + PVI solution and 51 patients who underwent surgical procedures with the FloShield Air System. The primary outcome measure was the number of laparoscope removals during surgery. Secondary outcome measures were the time to clean, assessment of the quality of vision, the correlation between the laparoscopic surgical complexity and outcomes, and cost effectiveness. RESULTS Overall, the mean patient age was 43.2 years (range 22-86) and body mass index 24.8 (range 16.8-42.7). The mean number of endoscope removals during surgery was 7.0 (range 0-37) in the water + PVI solution arm and 2.8 (range 0-12) in the FloShield Air System® arm. The number of removals was significantly lower in the FloShield arm (p < 0.001). No difference in time to clean, quality of vision, level of laparoscopic procedure complexity, or cost was observed between the groups. CONSLUSIONS The FloShield Air System® resulted in fewer laparoscopic lens removals than the water + PVI solution solution, but that there was no difference in quality of vision, cleaning time or cost, especially for the more complex surgery.
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Manning TG, Perera M, Christidis D, Kinnear N, McGrath S, O'Beirne R, Zotov P, Bolton D, Lawrentschuk N. Visual Occlusion During Minimally Invasive Surgery: A Contemporary Review of Methods to Reduce Laparoscopic and Robotic Lens Fogging and Other Sources of Optical Loss. J Endourol 2017; 31:327-333. [DOI: 10.1089/end.2016.0839] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Todd G. Manning
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
- Young Urology Researchers Organisation (YURO), Melbourne, Australia
| | - Marlon Perera
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
- Young Urology Researchers Organisation (YURO), Melbourne, Australia
| | - Daniel Christidis
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
- Young Urology Researchers Organisation (YURO), Melbourne, Australia
| | - Ned Kinnear
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
| | - Shannon McGrath
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
- Young Urology Researchers Organisation (YURO), Melbourne, Australia
| | - Richard O'Beirne
- Department of Engineering (Chemical), University of Melbourne, Melbourne, Australia
| | - Paul Zotov
- Young Urology Researchers Organisation (YURO), Melbourne, Australia
| | - Damien Bolton
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
| | - Nathan Lawrentschuk
- Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
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Simple, rapid and effective technique for intracorporeal defogging of laparoscopic lens. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s13126-016-0320-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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