Intraperitoneal Carbon Dioxide Concentration Measurement During Standard Laparoscopy With a New Airseal Access Port

Study Overview
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Brief Summary
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The new AirSeal access port for laparoscopic surgery does not use a mechanical valve on the port to maintain gas in the peritoneal cavity. It uses an invisible barrier created by high flow gas jets within the port. The percentage of carbon dioxide, the standard gas used for laparoscopy, during laparoscopic surgery has not been previously measured, but is probably high. The investigators aim to measure the percentage of intraperitoneal carbon dioxide with standard ports and the AirSeal port during a variety of conditions during laparoscopic procedures including suturing and suctioning. The study period will commence at the start of the operation, and be completed upon discharge from the hospital or postoperative day 5, whichever is shorter. All devices are approved for use in humans by the FDA, and are being used for their intended purpose.

Detailed Description
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The SurgiQuest AirSeal system is approved by the Food and Drug Administration (FDA) as access port for laparoscopic surgery that utilizes an invisible air curtain rather than a mechanical barrier to maintain pneumoperitoneum. In addition to the cannula, there is special filtration tubing and an air pump that act in concert with an existing CO2 insufflator. The system has been approved for use and purchase at Baystate Medical Center by the value analysis committee. Despite FDA approval and extensive laboratory testing, there is still no human data regarding intraperitoneal CO2 levels under a variety of conditions one would normally experience during a laparoscopic operation. The specific aim of this study is to measure these levels during laparoscopic cases in humans. We hypothesize that there will be no more than minimal alteration of intraperitoneal CO2 levels when using the AirSeal system when compared to the standard laparoscopic system. The follow-up to this is examining evidence of extraperitoneal gas extravasation. This will occur as part of routine post-operative care, but we will be collecting data, that will be de-identified in the post-operative period.

Official Title
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SurgiQuest AirSeal CO2 Gas Quality

Conditions
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Laparoscopic Carbon Dioxide Measurement

Intervention / Treatment
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* Device: Airseal access port for laparoscopic surgery
* Device: Standard Laparoscopy ports


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all patients undergoing a laparoscopic operation Exclusion Criteria: pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Airseal port for laparoscopic surgery<br>Airseal access port for laparoscopic surgery with standard ports. | Device: Airseal access port for laparoscopic surgery<br>* The investigators will utilize this access port that is already approved by the FDA for it's intended use in laparoscopic surgery. The investigators are simply measuring the percentage of carbon dioxide in the peritoneal cavity.<br>Device: Standard Laparoscopy ports<br>* Prospective monitoring of CO2 levels during laparoscopic surgery with standard access ports.<br>|
| Standard Laparoscopy ports<br>Uses standard laparoscopy ports. | Device: Standard Laparoscopy ports<br>* Prospective monitoring of CO2 levels during laparoscopic surgery with standard access ports.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| percent of intraperitoneal carbon dioxide during surgery | intraperitoneal carbon dioxide measurements intraoperatively | intraoperative - starts at beginning of the operation and ends at the completion of the operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| subcutaneous emphysema |  | during the patients hospital stay, or the first 5 days postoperatively. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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laparoscopy, airseal, carbon dioxide, insufflation, pneumoperitoneum