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  5. A CFD Analysis of Gas Leaks and Aerosol Transport in Laparoscopic Surgery
 
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A CFD Analysis of Gas Leaks and Aerosol Transport in Laparoscopic Surgery

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Author(s)
Crowley, Caroline 
Cahill, Ronan 
Nolan, Kevin Patrick 
Uri
http://hdl.handle.net/10197/13075
Date Issued
20 July 2022
Date Available
18T10:43:31Z August 2022
Abstract
Gas used to distend the abdomen during laparoscopic surgery is released to the external environment when trocar internal valves are opened during instrumentation. Particulate matter, including smoke pollutants and both biological and microbial materials, may be transported within the leakage gas. Here, we quantify the percentage of particulate matter that escape to the airspace and put surgical staff at risk of inhalation using a high-fidelity computational fluid dynamics model, validated with direct Schlieren observation of surgery on a porcine cadaver, to model the gas leak occurring due to the opening of 12 mm trocar valves around insertion/extraction of a 5 mm laparoscopic instrument. Fluid flow was modeled through the internal double-valved geometry of the trocar to a large external region representing the operating room (OR) space. Aerosol particles in the range 0.3–10  μm were injected into the simulation. A range of intra-abdominal pressures (IAPs) and leakage durations were studied. For gas leak durations of 0.5–1 s, at least 65% of particles reach the surgical team's breathing zone across all IAPs. A typical leak had an estimated volume of 0.476 l of CO2 meaning for a typical laparoscopic operation (averaging 51 instrument exchanges), and 24.3 l escapes via this mechanism alone. Trocar gas-leak emissions propel considerable gas and particle volumes into the OR. Reducing the IAP does not mitigate their long-range travel. This work indicates the potential for powerful computational tools like large eddy simulation to play an impactful role in the design of medical devices such as surgical trocars where complex gas dynamics occur.
Sponsorship
European Commission Horizon 2020
Type of Material
Journal Article
Publisher
AIP
Journal
Physics of Fluids
Volume
34
Issue
8
Copyright (Published Version)
2022 Author
Keywords
  • Complex fluid dynamic...

  • Laparoscopic surgery ...

  • Gas leakage

  • COVID-19

  • Coronavirus

DOI
10.1063/5.0097401
Language
English
Status of Item
Peer reviewed
ISSN
1070-6631
This item is made available under a Creative Commons License
https://creativecommons.org/licenses/by/3.0/ie/
Owning collection
Mechanical & Materials Engineering Research Collection
Scopus© citations
0
Acquisition Date
Jan 28, 2023
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