PubMed · 11721769
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R E Kravetz. 2001. Sphygmomanometer.. https://doi.org/10.1111/j.1572-0241.2001.05279.x
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BACKGROUND: This study aims to create new ergonomic guidelines for the design of foot pedals used during surgery. METHODS: Observations in the operating room, a questionnaire among 45 laparoscopic surgeons/residents, an ergonomic literature study, and clog measurements were used to assess the problems occurring during use and to compile new guidelines for foot pedals. Based on these guidelines a new foot pedal was designed and a prototype was manufactured. RESULTS: During the surgical procedure 91% of the subjects occasionally loses contact with the foot pedal, which 56% experience as very annoying. All subjects think that the current foot pedals obstruct their freedom of movement; 75% occasionally hit the wrong switch and 53% experience physical discomfort in their legs and/or feet. Therefore, 93% of the subjects would like to control the diathermy in a different way. The new prototype of a foot pedal was evaluated in a pilot test and proved to be ergonomically better than the currently used foot pedals. CONCLUSION: The new guidelines for foot pedals result in an ergonomic improvement in their design.
An Er:YAG laser light delivery system composed of a polymer-coated silver hollow waveguide and a quartz sealing cap has been developed for calculus fragmentation. Sealing caps with various distal-end geometries were fabricated, and the focusing effects of these caps for Er:YAG laser light were measured both in air and in water. Owing to the high power capability of the quartz a beam of sealing caps, Er:YAG laser light with an output energy of 200 mJ and a repetition rate of 10 Hz was successfully transmitted in saline solution by use of the system. Calculus fragmentation experiments conducted in vitro showed that the delivery system is suitable for medical applications in lithotripsy. We also found that the cap with a focusing effect is more effective in cutting calculi. The deterioration of the sealing caps after calculus fragmentation is also discussed.
BACKGROUND: Recently, several animal studies showed that the core body temperature falls during pneumoperitoneum, and this hypothermia could be prevented by using heated and humidified gas insufflation. However, there are no satisfactory heated humidifiers to meet this purpose. Therefore, we developed a new membrane-type heated humidifier. MATERIALS AND METHODS: The newly developed heated humidifier employs an ion-exchange membrane (Nafion: Du Pont Co. Ltd) tube that passes water selectively in molecular form and a gas compartment is completely separated from distilled water to prevent infection. This humidifier consists of a Nafion tube assembly and a case that includes the heater. A perforated protecting tube is located outside the Nafion tube to prevent direct contact with the Nafion tube when it is assembled. The Nafion tube assembly is inserted in the case, and dry gas flows inside of the Nafion tube. The space between the case and the Nafion tube assembly is filled with distilled water. A heater raises the temperature of the distilled water, and heat and water vapor are transferred to cold and dry gas through the Nafion membrane. Four different types of insufflators were involved in this performance comparison study: a Nafion-based heated and humidified insufflator, a conventional heated insufflator, a conventional heated and humidified insufflator, and a conventional cold and dry insufflator. Temperature and relative humidity were measured once each minute for 15 min, which was repeated four times. Each insufflator was operated at two rates of flow: 5 L/min and 10 L/min. RESULTS: Temperature and humidity of the conventional cold and dry insufflator, the Nafion membrane-type heated and humidified insufflator, the conventional heated insufflator, and the conventional heated and humidified insufflator measured at the distal end of circuit reached 22.0 +/- 0.2 degrees C and 0%, 36.7 +/- 1.1 degrees C and 100%, 29.0 +/- 0.4 degrees C and 0%, and 31.3 +/- 0.4 degrees C and 70.5 +/- 5.3% in 15 min at 5 L/min flow rates. At 10 L/min flow rates, temperature and humidity were almost the same as those at 5 L/min. The membrane-type heated humidifier demonstrated statistically significant improvement in both the temperature ( p < 0.0001) and relative humidity ( p < 0.0001) parameters in comparison to the conventional normal, heated, or heated and humidified insufflators at 5 L/min and 10 L/min continuous flow rate in statistics using repeated-measure ANOVA. CONCLUSION: This newly developed heated humidifier offers the great advantages of maintaining intraabdominal temperature and humidity in comparison to conventional insufflators for laparoscopic surgery.