Prospective, randomized comparison of the use of FloShield Air System® versus the reference technique (water + povidone-iodine solution) during gynecologic endoscopic surgery to evaluate the operative lens vision quality

Background The FloShield Air System ® is a new device for laparoscopic surgery that utilizes a continuous dry CO 2 gas flow over the scope to defog the lens and protect it from condensation, debris and smoke. We set out to compare the performance and efficiency of the device in terms of operative lens vision quality (OLVQ) with the reference technique (water + povidone-iodine (PVI) solution) during gynecologic laparoscopic surgery. Materials and methods We conducted a single-center randomized prospective study between March and June 2016 (Trials Database Registration NCT02702531) including 53 patients undergoing gynecologic laparoscopic surgery with water + PVI solution and 51 patients who underwent surgical procedures with the FloShield Air System. The primary outcome measure was the number of laparoscope removals during surgery. Secondary outcome measures were the time to clean, assessment of the quality of vision, the correlation between the laparoscopic surgical complexity and outcomes, and cost effectiveness. Results Overall, the mean patient age was 43.2 years (range 22–86) and body mass index 24.8 (range 16.8–42.7). The mean number of endoscope removals during surgery was 7.0 (range 0–37) in the water + PVI solution arm and 2.8 (range 0–12) in the FloShield Air System ® arm. The number of removals was significantly lower in the FloShield arm ( p