Suction Elevator for Ear Surgery

Otolaryngologic Clinics of North America, 2013

The operating microscope requires wide viewing portals for adequate illumination and visualization of the operative field, contrary to the endoscope, which provides direct vision with illumination to the target field, thus avoiding the need for extra exposure and extra drilling. When planning an exclusive endoscopic ear surgery, still the microscope is an essential part of the surgical setting making it ready to use whenever needed. Combining the attributes of microscope and endoscope during surgery is the most efficacious approach. Cholesteatoma resection is considered complete only after a final survey with the angled endoscopes is completed, confirming absence of pathologic conditions from all hidden recesses. The principal advantage of aspiration instruments is the ability to perform dissection and aspiration maneuvers at the same time overcoming the impact of operating with one hand as imposed by otoendoscopic surgery. The main limit of instruments with suction channels is the possibility of occlusion caused by detritus aspirated during dissection.

Cureus, 2021

To determine the loudness of suctioning in the ear canal with different-sized suctions and various mediums. Aural microsuctioning is commonly used in the otolaryngologist's office setting for cerumen removal and aural toilet. We hypothesize that the intensity of the sound would increase with increasing viscosity of the medium and increasing suction diameter. Methods The intensity of the sound generated was measured while suctioning air, water, and yogurt on cadaveric temporal bones with size 7 and 5 Frazier suctions. This was performed with one measurer and one operator. Under otomicroscopy, the operator would suction the ear canal and the measurer would record the intensity of the sound with a sound decibel meter placed at the lateral and posterior external auditory canal. Data was collected with two separate operators and measurers to aid with inter-rater reliability. Results There was a total of 240 repeated observations (10 cadavers, 3 mediums, 2 suction devices; 2 investigators). The range of the maximum peak intensity ranged from 63.0 dB to 100.0 dB. The lowest peak intensity of decibels was recorded in air with the size 5 Frazier suction; and the highest measured was with the size 5 Frazier suction in yogurt. Statistically significant differences were found only in the measurements in air. Conclusion Our investigation found that increasing peak sound intensities were generated by increasing the viscosity of the fluid medium that was being suctioned. However, the smaller sized diameter suction actually generated louder sound intensities than the larger diameter suction with higher viscosity fluid media, but this was not statistically significant.

In minimal access surgery (MAS) (also known as minimally invasive surgery), operations are carried out by making small incisions in the skin and inserting special apparatus into potential body cavities through those incisions. Laparoscopic MAS procedures are conducted in the patient's abdomen. The aim of MAS is faster recovery, shorter hospitalisation and fewer major post-operative complications; all resulting in lower societal cost with better patient acceptability. The technique is markedly dependent on supporting technologies for vision, instrumentation, energy delivery, anaesthesia, and monitoring. However, in practice, much MAS continues to take longer and be associated with an undesirable frequency of unwanted minor (or occasionally major) mishaps. Many of these difficulties result precisely from the complexity and mal-adaptation of the additional technology and from lack of familiarity with it. A survey of South East England surgeons showed the two main stress factors on surgeons to be the technical difficulty of the procedure and time pressures placed on the surgeon by third parties.

Ear, nose & throat journal, 2006

We conducted a study to evaluate the use of a pediatric rigid otoendoscope for determining the extent of middle ear disease and for assessing ossicular integrity and mobility during tympanoplasty. Our study population was made up of 132 patients who were undergoing surgery for the treatment of chronic suppurative otitis media; of this group, 41 patients underwent otoendoscopy and 91 underwent scutum lowering for purposes of visualization. In the otoendoscopy group, the ossicles were successfully visualized and their mobility assessed in 34 patients; the remaining 7 patients subsequently underwent scutum lowering. A 30 degrees endoscope allowed for complete visualization of the middle ear in almost all of the 34 cases. The mean duration of surgery for the 34 patients in the otoendoscopy group was 62.85 minutes (+/- 15.57), which was significantly shorter than the duration of surgery (71.23 +/- 15.65 min) for the 98 patients who underwent scutum lowering (p < 0.005). A total of 50 ...

European Archives of Oto-Rhino-Laryngology, 2012

The objectives of this study were to evaluate noise levels generated during micro-suction aural toilet using an anatomic silicon ear model. It is an experimental study. In an anatomic ear model made of silicone, the eardrum was replaced by a 1-cm diameter microphone of a calibrated sound-level measuring device. Ear wax was removed using the sucker of a standard ENT treatment unit (Atmos Servant 5 Ò). Mean and peak sound levels during the suction procedure were recorded with suckers of various diameters (Fergusson-Frazier 2.7-4 mm as well as Rosen 1.4-2.5 mm). Average noise levels during normal suction in a distance of 1 cm in front of the eardrum ranged between 97 and 103.5 dB(A) (broadband noise). Peak noise levels reached 118 dB(A). During partial obstruction of the sucker by cerumen or dermal flakes, peak noise levels reached 146 dB(A). Peak noise levels observed during the so-called clarinet phenomena were independent of the diameter or type of suckers used. Although microsuction aural toilet is regarded as an established, widespread and usually safe method to clean the external auditory canal, some caution seems advisable. The performance of long-lasting suction periods straight in front of the eardrum without sound-protecting earwax between sucker and eardrum should be avoided. In particular, when clarinet phenomena are occurring (as described above), the suction procedure should be aborted immediately. In the presence of dermal flakes blocking the auditory canal, cleaning with micro-forceps or other non-suctioning instruments might represent a reasonable alternative.

Journal of Biomedical Science and Engineering, 2014

Laryngoscopy is a medical procedure that provides a secure airway by passing a breathing tube through the mouth and into the lungs of a patient, and to perform meconium suction in newborns to avoid asphyxia. The ability to successfully perform meconium suction is highly dependent on operator skill and the availability of trained assistants to assist during the procedure. The immediate objective of this research paper is to present an improved device, so that the procedure can be performed at a faster pace and the need for assistants is eliminated. Experienced physicians have used the device presented in the paper on mannequin, and the operating time and ease were observed to have improved.

2008

Purpose: Aspiration of intra abdominal fluid and debris is usually needed during different stages of the operation. This is necessary in order to protect the intra abdominal space from contamination and/or to remove blood or tissue fluids that may occur during the operation. It is also essential for obtaining a clean surgical area. Aspiration of intra abdominal fluid collecting in Douglas Pouch is difficult, even with the use of lower abdominal incisions such as phannensteal. Aspiration of intra abdominal fluid collecting in the Douglas Pouch becomes more difficult when an upper abdominal incision is used because of the difficulty of access to the Douglas Pouch and suctioning the omentum and intestine with the aspirator. Materials and Methods: In this study, a modified suction device (Suction Tube with Air Channel =STAC) has been reported which allows the surgeon easier suctioning intra abdominal fluid. Results: STAC has an additional air channel which prevents the device from sucti...

World Neurosurgery, 2011

Ⅲ OBJECTIVE: Spinal surgical procedures share the technical difficulty of having to preserve the integrity of the dura mater in a surgical field with different degrees of hemorrhage. This difficulty is particularly evident in the surgery of degenerative diseases. Ⅲ METHODS: We have developed a new surgical sucker that allows an easy dissection of the dural sac from adjacent structures and improves the overall surgical manipulation during degenerative lumbar spinal procedures. The present technical note describes this newly developed suction device that comprises a slightly oval spatula positioned at an angle of 30°to the bore of the suction tube. Ⅲ RESULTS AND CONCLUSION: Attending to the combination of a spatula and a suction device, it offers several advantages when compared to the instruments that are currently available. Namely, it facilitates the dissection of the ligamentum flavum from the subjacent dura mater, separating and holding this ligamentum from the dura mater; it also allows a slight retraction of the dural sac without direct suction and a better illumination of the surgical field through light reflected from the spatula.

2010 IEEE International Conference on Robotics and Automation, 2010

In this article, a new Micromanipulator System (MMS-II) for middle ear surgery is presented. The purpose of this work was to develop a simple but effective manipulator that would enable the surgeon to move standard surgical instruments in a precise way even under non-ergonomic conditions. The MMS-II is lightweight, small, and easy to use; it requires no PC, besides a small microcontroller-based joystick console. Such features, together with a practicable sterilization concept and the availability of a multiplicity of surgical instruments, allow the system to be used in standard surgical procedures.

Ent Ear Nose Throat Journal, 2006

We conducted a study to evaluate the use of a pediatric rigid otoendoscope for determining the extent of middle ear disease and for assessing ossicular integrity and mobility during tympanoplasty. Our study population was