Laparoscopic Pneumoperitoneum Escape and Contamination during Surgery using the Airseal Insufflation System: Video Vignette

Dalli, Jeffrey; Khan, Mohammad Faraz; Nolan, Kevin; Cahill, Ronan A

Unanticipated behaviours of the Airseal Insufflation and Access System (Conmed, NY, USA), in the public domain since 2017, have been recently restated by the manufacturer in light of the COVID19 pandemic and widespread concerns regarding aerosolization hazards during surgery. The associated video illustrates this device’s tendency for intra‐abdominal gas effluvium to be continually blown into the operating room during use as well as the phenomenon of air entrainment (i.e. the tendency for room air to be sucked into the abdomen) during high pressure intraoperative suctioning. We used a combination of assessment technologies in a high‐fidelity simulation model (fresh porcine cadaver) as well as during clinical surgery to examine gas flow through the Airseal 12mm valve‐less trocar with the Airseal IFS carbon dioxide (CO(2)) insufflator in Airseal mode.