Dirty Trocar Study
A study was conducted to evaluate this problem. This study comprised three parts: a questionnaire was sent to surgeons performing thoracic procedures, data was collected during thoracoscopic operations, and a literature study was done in the patents index. The questionnaire was sent to 210 surgeons. Sixty-eight of them replied. During 44 operations, the following data was recorded: Type and duration of the operation, and number of times the lens and the trocar had to be cleaned. On the Internet and in a patents’ index, a search was conducted on the key words “thoracoscopy,” “trocar” and “bleeding.” All solutions for the problem mentioned above were listed. Ninety-seven percent of surgeons answered and recognized the problem, and 68% of the respondents considered a troublesome one. In 41% of the operations, the problem didn’t occur, meaning it was not necessary to clean either the lens or the cannula. In 34%, it happened one to two times, and in 25% of the procedures it occurred even more often. If it occurred, the scope had to be cleaned on average once in about 10 minutes and the trocar had to be cleaned once in about 15 minutes. The longer the operation lasted the more often the lens and/or the trocar had to be cleaned. Of the 11 procedures that lasted less than 15 minutes, the trocar was never cleaned, and the lens had to be wiped only 0.18 times per procedure. Of the 18 procedures that lasted more than 20 minutes, the lens was cleaned 2.8 times per procedure and the trocar 1.6 times per procedure. Soiling of the endoscope during thoracoscopic procedures is a real concern that calls for a new technical solution to make video-assisted thoracic surgery easier for the surgeon and safer for the patient.