新型双通道腹腔镜排烟装置有效性研究

doi:10.3877/cma.j.issn.1674-3253.2025.06.015

目的

设计研发一种新型双通道腹腔镜排烟装置，并验证其排烟效果。

方法

在体外透明腹腔镜模拟箱中，使用超声刀、双极电凝抓钳抓取鸡脂肪，比较安装新型双通道排烟装置组（研究组）与安装传统排烟装置组（对照组）模拟箱内烟雾颗粒计数。使用腹腔镜镜头以远距离、中距离、近距离观察实验操作，记录100次操作中各组镜头被污染次数。

结果

排烟测试中，研究组测得直径0.3 μm颗粒[（1 329 247±159 800）vs （24 123 431±9 366 698）个/L，P=0.006]，0.5 μm颗粒[（339 856±96 857） vs （3 037 262±1 038 992）个/L，P<0.001]，1.0 μm颗粒[（60 542±38 500）vs （779 007±96 318）个/L，P<0.001]，2.5 μm颗粒[（4 938±1 938）vs （89 846±20 408）个/L，P<0.001]，5.0 μm颗粒[（1 365±414）vs（42 649±8 489）个/L，P<0.001]，10.0 μm颗粒[（36± 17）vs （2 797±1 094）个/L，P<0.001]均显著小于对照组。在镜头防污染效果测试中，研究组在腹腔镜镜头中距离（5 cm）观察手术操作时被污染次数（13/100 vs 27/100次，P=0.013），镜头近距离（3 cm）观察操作被污染次数（18/100 vs 40/100次，P<0.001），较对照组少。

结论

新型双通道排烟装置能够有效排烟、保持腔镜手术中手术视野的清晰。

关键词: 腹腔镜, 排烟装置, 手术烟雾, 双通道, 医疗器械设计, 职业暴露

Objective

A laparoscopic novel dual-channel smoke evacuation device was designed, and its smoke exhaust effect was verified.

Methods

In the in vitro transparent laparoscopic simulation box, the chicken fat was grasped by ultrasonic knife and bipolar electrocoagulation forceps, and the novel dual-channel smoke evacuation device installed group (study group) and the traditional smoke extraction device installed group (control group) were compared. The smoke particle count in the simulated box was measured. The laparoscopic lens was used to observe the experimental operation at different distance, and the number of times the lens contaminated during 100 operations was recorded.

Results

In the smoke evacuated experiment, the number of particles measured in the study group about 0.3 μm particles [(1 329 247 ± 159 800) vs (24 123 431 ± 9 366 698), P=0.006], 0.5 μm particles [(339 856 ± 96 857) vs (3 037 262 ± 1 038 992), P<0.001], and 1.0 μm particles [(60 542 ± 38 500) vs (779 007 ± 96 318), P<0.001], 2.5 μm particles [(4 938 ± 1 938)vs (89 846 ± 20 408), P<0.001], 5.0 μm particles [(1 365 ± 414) vs (42 649 ± 8 489), P<0.001], 10.0 μm particles [(36 ± 17) vs (2 797 ± 1 094), P<0.001] were significantly lower than those in the control group. In the experiment of lens anti-pollution effect, the number of contaminated operations observed by the study group at middle distance (5 cm) (13/100 vs 27/100 times, P=0.013) and the number of contaminated operations observed by the lens at close distance (3 cm) (18/100 vs 40/100 times, P<0.001) were significantly fewer than those in the control group.

Conclusion

The novel dual-channel smoke evacuation device can effectively evacuate smoke and maintain a clear surgical field of view during laparoscopic surgery.

Key words: Laparoscopy, Smoke extraction device, Surgical smoke, Dual-channel, Equipment design, Occupational exposure

图1 新型双通道腹腔镜排烟装置展示注：a为新型双通道排烟装置设计图，呈双通道管状结构，主要部件由管状主体、进气管路、出气管路、密封套组成；b为排烟装置尾端特写，由密封套及进出气管路延长管组成；c为排烟装置头端特写，有进气管路出口及出气管路出口；d为装置使用示意图，排烟装置套装于能量器械上，管路延长管分别接负压吸引器与气腹机

图2 新型双通道腹腔镜排烟装置体外实验示意图及镜下实际效果展示注：a为体外实验使用的激光粒子计数器；b为体外实验示意图，包括透明腹腔镜模拟箱、安装排烟装置的能量器械、腹腔镜镜头及实验使用的鸡脂肪；c为近距离观察下，传统排烟装置的双极电凝抓钳电凝鸡脂肪效果图；d为近距离观察下，安装排烟装置的双极电凝抓钳电凝鸡脂肪效果图

表1 两组腹腔镜排烟装置体外排烟效果测试中烟雾颗粒数量对比（个/L，

±s）

组别	颗粒直径
组别	0.3 μm	0.5 μm	1.0 μm	2.5 μm	5.0 μm	10.0 μm
研究组	1 329 247±159 800	339 856±96 857	60 542±38 500	4 938±1 938	1 365±414	36±17
对照组	24 123 431±9 366 698	3 037 262±1 038 992	779 007±96 318	89 846±20 408	42 649±8 489	2 797±1 094
t值	-5.441	-5.780	-15.488	-9.261	-10.862	-5.640
P值	0.006	<0.001	<0.001	<0.001	<0.001	<0.001

表1 两组腹腔镜排烟装置体外排烟效果测试中烟雾颗粒数量对比（个/L，

±s）

组别	颗粒直径
组别	0.3 μm	0.5 μm	1.0 μm	2.5 μm	5.0 μm	10.0 μm
研究组	1 329 247±159 800	339 856±96 857	60 542±38 500	4 938±1 938	1 365±414	36±17
对照组	24 123 431±9 366 698	3 037 262±1 038 992	779 007±96 318	89 846±20 408	42 649±8 489	2 797±1 094
t值	-5.441	-5.780	-15.488	-9.261	-10.862	-5.640
P值	0.006	<0.001	<0.001	<0.001	<0.001	<0.001

表2 两组镜头防污染效果100次实验中镜头污染次数对比

组别	远距离7 cm	中距离5 cm	近距离3 cm
研究组	7	13	18
对照组	15	27	40
χ²值	3.269	6.125	11.753
P值	0.071	0.013	0.001

表2 两组镜头防污染效果100次实验中镜头污染次数对比

组别	远距离7 cm	中距离5 cm	近距离3 cm
研究组	7	13	18
对照组	15	27	40
χ²值	3.269	6.125	11.753
P值	0.071	0.013	0.001

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Study on the effectiveness of a novel dual channel laparoscopic smoke evacuation device

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Study on the effectiveness of a novel dual channel laparoscopic smoke evacuation device