Medical Vision® leads the development in Fluid Management in endoscopic surgery, to facilitate better visualization during surgery. Through our arthroscopy pump, Double® Pump, we have the most advanced and high-tech pump on the market, which leads to more controlled and shorter procedures as well as better patient outcomes. We claim that proper fluid management is essential to perform a successful arthroscopy in any joint in the body; therefore we strive to further expand the knowledge of the fluid management segment and its importance during an arthroscopic surgery.
Double® Pump controls both in- and outflow, that is both pressure and flow in a separate fashion. The pump operates with disposable cassettes, one that controls the in-flow (Day Cassette, used for one surgical day) and one that controls the out-flow (Patient Cassette, new for every patient).
We welcome you to test Double® Pump and compare it to the pump you are using today. Through the features mentioned above we are certain that you will note the difference.
Most arthroscopy pumps on the market use tubes instead of cassettes. Tubes require a more delicate setup which can result in pump inconsistency since the tube position can vary from case to case – it is normally also more time consuming. Double® Pump uses cassettes instead of tubes. The cassette house on the pump is designed to easily fit the cassette, which makes it easy and quick to mount. The cassettes snaps into place with a click sound and are easily removed by unlatching the cassette with the lever. The Double® Pump cassettes have some other unique features:
The patented algorithm which calculates the true IAP
(Intra Articular Pressure).
The Cassettes are packaged in trays instead of
pouches, which both prevents from dropping on
the floor, but also makes them easier to keep sterile.
Behind the Double® Pump Patient Cassette, the Smart- Vision® optical sensor is located. With this sensor the Double® Pump can automatically adjust pressure and flow when blood or debris is detected.
The reason for using a pump and the whole idea with fluid management during an arthroscopic procedure is to:
It is fundamental to maintain an adequate pressure level throughout the surgery in order to ensure optimal visibility for the surgeon during the procedure and thereby secure better outcome for the patient. A controlled and accurate pressure will potentially also implicate a more controlled and quicker procedure. Therefore, clinically correctly measured pressure in the joint and an appropriate, case-by-case, automatical adjustment of the pressure, are features that have been proven to be crucial to get a controlled and cost-efficient end result, when performing arthroscopic procedures today1.
One of the major concerns with the arthroscopic procedure involves the extravasation of fluid into the surrounding soft tissues. This situation occurs when the pump system used delivers a pressure that is much too high versus the pressure in the surrounding soft tissue. Particularly fluid diffusing into the soft tissues of the shoulder and periscapular region can be much more than just an inconvenience. Therefore, it is absolutely essential to control the pressure and keep it as low as possible during the procedure, while still maintaining sufficient pressure to keep the joint distended.
In order to keep a constant visibility during the procedure it is essential that the pump system used, can control both in- and outflow. With an irrigation-only pump system pressure is built up gradually in the joint and when fluid is evacuated, either through removal of the optic scope or via an external suction source, the pressure is dropped dramatically. This results in bleeding from damaged vessels and loss of the distention effect earlier given by the pump. It is therefore fair to state that lack of continuous flow, such as an in- and outflow pump can provide, makes the procedure much more complicated.
In order for a pump with both inflow and outflow functionalities to work as intended, there must be proper physical conditions for the fluids to move in and out of the joint. If the inflow port, e.g. the scope sheath, has a narrow space for the fluids to flow, no pump-system in the market can establish a proper and sufficient flow through the joint.
Therefore, it is essential to use a high-flow scope sheath when prioritizing good visibility during the procedure. If you do not have a proper outflow the fluids have no place to go – it has to be evacuated either through the scope sheath or the Shaver suction, with a pressure influencing effect as described above. Therefore we claim that proper fluid management is performed with an inflow and an outflow pump that dynamically controls the pressure and flow levels. Below we will explain in detail what we mean with a dynamic control.
The technology, branded as SmartVision®, is a revolutionary solution to visibility problems during endoscopic surgery performed in conjunction with a fluid management system. When SmartVision® is in use, the pump system through an optical sensor, detects substances that have influence on the visibility during surgery. The SmartVision® adjusts flow and pressure dynamically and automatically in the operation site so that full visibility is maintained. SmartVision® is a patented technology by Medical Vision®.
SmartVision® gives the advantage of optimizing the pressure according to the visibility circumstances in the joint throughout the procedure. This result in a significantly lower average pressure and a shorter procedure time for the SmartVision® controlled pump compared to any other pump on the market. 2
In the pressure diagram, it clearly shows that a SmartVision® pump works with a significantly lower average pressure compared to a pump without SmartVision®. It also shows that the SmartVision® pump adjusts the pressure according to the visibility conditions in the joint.
The flow diagram shows how the flow increases once either blood or debris is detected. However, the flow level for the SmartVision® pump is dynamically adjusted, resulting in an optimized flow for any given part of the procedure.