Understanding Surgical smoke in Laparoscopy through Lagrangian Coherent Structures

TL;DR

This study analyzes the flow dynamics of surgical smoke in laparoscopic surgery using Lagrangian Coherent Structures derived from CFD models, providing insights for better instrument placement and smoke removal.

Contribution

It introduces a novel application of Lagrangian Coherent Structures analysis to understand surgical smoke transport in laparoscopic procedures.

Findings

Flow patterns depend on outlet configurations and inlet positions.

FTLE ridges identify vortex regions and accumulation zones.

Results inform optimal instrument placement for smoke removal.

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 planar 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.