Imagine a surgery procedure in which the continuous flow of oxygen is available only through oxygen bottles, and each bottle is enough for only 10 minutes, forcing the nurse to switch bottles constantly.
Imagine that the nurse does not switch the oxygen bottle on time, for various reasons, causing the patient to suffocate.
Imagine that the only way the surgeon understands the patient's dangerous situation is when the patient turns blue. The surgeon’s reaction in all likelihood would be to scream – NURSE!!!
The above situation, as outrageous as it sounds, happens daily when it comes to the supply of medical solutions (liquids). While the medical world has tools to ensure a continuous flow of oxygen (a central supply from a connection in the operating room wall to the patient), there is no solution for continuous flow of medical solutions or to use its medical term, "Continuous Irrigation."
Continuous irrigation is mandatory in some of the most common minimally invasive surgical procedures in Orthopedics, Urology, Genecology and other disciplines. As an example in TURP (resection of the prostate) any halt of the solution supply immediately stops the fluid pressure, which causes a "collapse" of the prostate and bladder, and creates an accumulation of blood that blocks the surgical site, stops the surgery and ultimately increases the patient's risks (pic. 2). At this point, the surgeon usually starts to scream – NURSE!!!
After the nurse rushes to regain the flow, it takes the surgeon a few minutes to return the volume of the prostate and bladder to its previous level, to stop blood flows and to clean blood clots. Only then can the surgeon continue with the surgery. This procedure happens daily in hospitals worldwide and causes stress to medical teams, waste of valuable operating rooms' time, waste of medical teams' time, and increases in patient risks.
Picture 1. Surgeon’s View:
Blood streams from the dissected prostate cleaned by the solution flow
Picture 2. Surgeon’s View:
A halt in the supply of the solution causes a block of the surgeon’s view
Medical Solution Supply: The Current Situation
The current method of supplying a continuous flow of solution is to manually switch solution bags. Prior to the surgery, the nurse hangs two 3-liter bags of medical solution on a pole (pic. 3) and removes their protective covers. With special "Y set" plastic tubes (pic 4), the nurse spikes the two bags (pic. 5) and connects the other side of the Y-set to the resectoscope (pic. 6).
When the surgery begins, the nurse opens the path on one side of the Y-set, thus enabling the solution to flow by gravity to the resectoscope. When the first bag is close to empty, the nurse opens the path of the fluid from the second bag, closes the path from the empty bag and replaces the empty bag with a new one.
This bag-switching procedure happens every 10 minutes and depends entirely on the alertness of the nurse. The much-needed continuous solution flow stops in the middle of about 15-20% of all surgeries.
Another common situation that happens during the surgery is blocking the surgeon's vision by excess bleeding. In these cases the surgeon requests the nurse to increase the flow by elevating the solution bag or by pressing it in order improve his visibility. This increase of pressure and flow is uncontrolled and may bring higher risk to the patient.