Insufflator

Everything you need to know about insufflators

 

How do surgeons perform surgeries so flawlessly without even being able to see everything with the naked eye? This is a question that arises to many of us, but a wise doctor once invented such a device that evolved medical history to how we know it today. The invention was called an insufflator. Insufflators are one of the most frequently used medical devices in a hospital setting. More specifically, they are called "Automatic abdominal insufflators" or "laparoscopic insufflators." The device's primary purpose is to insufflate or blow a vapor, powder, or gas into an opening or cavity such as the abdomen. Insufflation has many medical uses; its most frequent use is as an administration route for many different drug types. The most common use of this device is in laparoscopic surgery, and the most common gas used during this procedure is carbon dioxide. Carbon dioxide is the preferable gas because its non-flammable dissolves easily in blood and is colorless. During laparoscopic surgery, it is essential that all areas are visible, so gasses are pumped into a cavity to enhance the regions required for visual inspections. There are not many steps to the procedure, but it is very hurtful and almost always given under anesthesia to ease the patient from pain. The proper knowledge about the machine is necessary. It should only be used by a perfectly skilled professional who is an expert in their work and perfectly knows what he or she is doing. This device and the procedure that follows its use has proven to be of great significance in the medical world and has evolved the practice of surgery forever. 

History 

In early 1927 a scientist named Kurt Semm started the first-ever research on the manufacture of an insufflator like this. The first insufflator invented was called the "Tubal Insufflator." His research had shown that this device would cause a condition similar to pneumoperitoneum. Later in the mid-1960s, Semm, who was now a gynecologist himself, was teaching at a renowned university. He risked all he had, such as his financial resources and career, to develop the first-ever one of a kind abdominal insufflation device. At that time, the term "laparoscopy" was frowned upon and had negative views with it. In 1967 the new name "pelviscopy" was introduced, and the invention was presented to Dr. Melvin Cohen at the meeting of the American Fertility Society, which was held in Washington. Since the beginning, this was trendy amongst the medical community; some reactions were very heated and pronounced Semm "mad," while others were growing fond of the invention. Many American physicians and instrument manufacturers appreciated the insufflator on the other side of the Atlantic and valued how easy it was to use, its clinical importance, and safety. The invention of the insufflator had brought possibilities no one ever knew were even possible. It evolved the thinking and approach of all medical practitioners who were against the production of such a device and deemed it harmful to use in medical procedures. It became popular so fast that it was demanded everywhere within just a few years. 

Indications for use

As with all medical equipment, there are always specific procedures or diseases when insufflators are required. Insufflator is needed when a surgery or medical procedure involves the process of insufflation. Insufflation is the process of blowing any gas, drug, powder into a body cavity. This procedure needs to be done by professional medical personal to avoid any complications and make sure the process is smooth and careful. The use of an insufflator is widespread in medicine, and there are many types of these devices available, each with their unique features of design based on function. 

The insufflator is essential to use to elevate abdominal walls from the vital organs to create a viewing space for the surgeon to work. The doctor performing the procedure must make many choices. The most important one being the choice of gas which depends on several factors such as,

  1. Type of anesthesia 
  2. Toxicity 
  3. Non-combustibility
  4. Safety 
  5. Cost 

There are many reasons we may need to administer this procedure, and some of them are described below:

  • Abdominal Surgery 

In abdominal surgery or laparoscopic surgery, the insufflator is used to pump carbon dioxide into the cavity to help make the operation area more visible. A visible region aids the doctor that is performing the surgery to have a clear Plainfield to work. This surgery involves the insufflation of gas (most commonly used is Carbon dioxide) into the peritoneal cavity. Thus, producing pneumoperitoneum. 

  • Respiratory assistance 

Oxygen is administered through a nasal cannula to assist in respiration for those with oxygen deficiency. It helps them to breathe better and provides oxygen to the body. 

  • Central nervous system injury and muscle weakness 

Mechanical insufflation stimulates a coughing mechanism that, in turn, helps clear the mucus in the airway. Which also helps the patient breathe better. 

  • Athletes

              Glossopharyngeal insufflation is a procedure that involves breathing techniques requiring the patient to gulp large boluses of air into the lungs. 

  • Life support 

Artificial ventilation techniques are used by large ventilator machines that pump air and breathe in place of the patient's lungs. 

  • Asthma patients 

Pump inhalers, also a form, are used for patients who have asthma.

  • Anesthesia and critical care

Insufflated gases and vapors function in oxygenating and ventilating patients. The insufflator is also used to maintain general anesthesia. 

  • Nasal Drug Administration

Administering drugs through a nasal passageway is a standard method of insufflation used. Medicines that are delivered this way have a more local or systemic effect. Examples of medications given this way are:

  • Steroids 
  • Hormone Replacement drugs 
  • Decongestants 
  • Nicotine Replacement drugs.
  • Migraine Medication 
  • Vaccines 

Advantages and disadvantages of using insufflators 

Advantages 

  • Routine Technique 
  • Airway Protection 
  • Clearing of airway 
  • Enhancement of the cavity for better view in surgery. 
  • Control of ventilation

Disadvantages

  • Limits surgical access 
  • Limits visibility 
  • Occlusion 
  • Higher resistance

The complications in using this tool

As with every medical device, many complications arise from the usage of insufflators. Many of the difficulties are minor and can be controlled and stopped immediately from causing further health issues. But as of now, there are not many reported complications with the use of these insufflation devices except for:

  • Nausea 
  • Bradycardia 
  • Tachycardia 
  • Abdominal distension 
  • Gastroesophageal reflux 
  • Aspiration 

All these complications are infrequent, and clinical experience indicates that these are uncommon. So, nothing to worry about when administering the use of this device. Not many precautions or preventive measures are needed.

General Specifications of this device

As the popularity of this device increases day by day, manufacturing has also expanded to meet with the demands. All manufactures are striving to produce the best insufflator in the market, which is why insufflators are now coming in various designs, but the base model remains the same.

General Specifications are: 

  • Dimensions: 15" W x 12" L x 6"H 
  • Weight: 24 lbs. (10.9 Kg) 
  • Voltage: 120 VAC 50/60 Hz 
  • Waveform: Sinusoid 
  • Operating frequency: 1.7 MHz 
  • Cost: $65-$5000

How they work 

Insufflators work to increase the intra-abdominal pressure and cause a pneumothorax. This procedure is painful and requires anesthesia and analgesics to ease the pain and calm the patient. Nitrous oxide insufflation seems to be less painful than carbon dioxide insufflation.

The procedure used is:

  1. The patient is injected with anesthesia and put to sleep. 
  2. The insufflator is attached to the patient accordingly and switched on. 
  3. Insufflation of carbon dioxide gas to the peritoneal cavity at the rate 4-6 liter min and pressure of 10-20 mm Hg
  4. Pneumoperitoneum of the cavity
  5. Increased intra-abdominal pressure.  
  6. Visibility available for the doctor to perform surgery. 

Market leaders

As the demand is increasing, more and more manufacturers are coming out with unique products. Each built with varying specifications to meet the needs of everyone using them. This market is said to be driven by factors such as popularity and the increase of minimally invasive surgery. All the manufacturers are striving to develop even better devices than the ones in the market now. 

The top manufacturers are:

  1. Conmed Corporation 
  2. B. Braun Melsungen AG 
  3. Ecleris S.R.L 
  4. Olympus Corporation 
  5. Maxerendoscopy 
  6. Stryker Corporation 
  7. Hospiinz International 
  8. COMEG 
  9. Smith and Nephew Plc. 

Conclusion

This invention has brought about an evolution in the medical world. It has helped surgeons save many lives and perform surgeries with ease. Although a painful procedure, it is imperative to carry out. Thanks to the research of Dr. Kurt Semm, this invention has become essential in every hospital and clinic. Without insufflators, it would be impossible to create a replica of pneumoperitoneum to help in creating a visible field for the surgeon to work. In conclusion, this device is a godsend and is essential in the medical field if used correctly.