Understanding surgical smoke in laparoscopy through Lagrangian Coherent Structures

PLoS One. 2023 Nov 14;18(11):e0293287. doi: 10.1371/journal.pone.0293287. eCollection 2023.

Abstract

In laparoscopic surgery, one of the main byproducts is the gaseous particles, called surgical smoke, which is found hazardous for both the patient and the operating room staff due to their chemical composition, and this implies a need for its effective elimination. The dynamics of surgical smoke are monitored by the underlying flow inside the abdomen and the hidden Lagrangian Coherent Structures (LCSs) present therein. In this article, for an insufflated abdomen domain, we analyse the velocity field, obtained from a computational fluid dynamics model, first, by calculating the flow rates for the outlets and then by identifying the patterns which are responsible for the transportation, mixing and accumulation of the material particles in the flow. From the finite time Lyapunov exponent (FTLE) field calculated for different cross-sections of the domain, we show that these material curves are dependent on the angle, positions and number of the outlets, and the inlet. The ridges of the backward FTLE field reveal the regions of vortex formation, and the maximum accumulation, details which can inform the effective placement of the instruments for efficient removal of the surgical smoke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bays
  • Humans
  • Hydrodynamics
  • Laparoscopy*
  • Smoke*

Substances

  • Smoke

Grants and funding

This work has been supported by the project PORSAV (Protecting Operating Room Staff Against Viruses) funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 101015941; and RAC also by Intuitive and Medtronic and IBM Reserach, Palliare and Arctur. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.