SeeClear™ MAX Laparoscopic Smoke Evacuation System

A member of the Reviews in Obstetrics & Gynecology editorial board has reviewed the following devices. The views of the author are personal opinions and do not necessarily represent the views of Reviews in Obstetrics & Gynecology or MedReviews, LLC.

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• Design/Functionality Scale

  • 1 = Poor design; many deficits
  • 2 = Solid design; many deficits
  • 3 = Good design; few flaws
  • 4 = Excellent design; few flaws
  • 5 = Excellent design; flaws not apparent
• Value Scale

  • 1 = Added cost with limited benefit
  • 2 = Added cost with some benefit
  • 3 = Added cost but significant benefit
  • 4 = Marginal added cost but significant benefit
  • 5 = Significant cost savings
• Overall Scale

  • 1 = Don’t bother
  • 2 = Niche product
  • 3 = Worth a try
  • 4 = Must try
  • 5 = Must have

Evaluation

Design/Functionality: 4.5

Value: 3.5

Overall Score: 3.5

Background

W. T. Bovie launched a new age of surgical hemostasis with the introduction of the electrosurgical unit in 1926. Unfortunately for the laparoscopist, where there is fire there is also smoke, which obscures the surgical field¹ and may present health hazards to operating room staff. Although the visual impediments are apparent, the health hazards of surgical plumes are debatable.

Surgical smoke or plume is a byproduct of the thermal destruction of human tissue. Chemical analysis has shown its constituents to be 95% water vapor and 5% chemical, of which hydrocarbons, nitriles, fatty acids, and phenols comprise the bulk. Of the phenols, formaldehyde, acrolein, mixtures of benzene, toluene, ethylbenzene, and xylene (BTEX), and polyaromatic hydrocarbons are of the most concern. With this mixture of noxious odors, irritants, and known carcinogens, the toxicity of surgical smoke is estimated to be similar to cigarette smoke.² The thermal destruction of 1 g of tissue is calculated as equivalent to 3 to 6 cigarettes.

Design/Functionality

The SeeClear™ MAX laparoscopic smoke evacuation system (JLJ Medical Devices International, LLC, Eden Prairie, MN) is brilliant in its simplicity. In essence, the device is a piece of tubing with a filter. The filter is a matrix of activated charcoal with ultra-low-penetration air (ULPA)- grade hydrophobic glass microfibers. It is US Food and Drug Administration (FDA) approved with an efficiency of 99.99% of 0.1-micron particles. The tubing connects to an open trocar sleeve port and smoke filters naturally through the abdomen via the filter. In testing, the device works as billed; the only deficit seems to be buildup of liquid in the filter in cases with excessive irrigation use if the filter lies at or below the level of the surgical field.

Design/Functionality Score: 4.5

Value

Priced at $21.50, the SeeClear MAX laparoscopic smoke evacuation system is relatively cheap by medical-device standards. Although it cannot compete with the cost of simply opening the trocar ports (free), it does match up nicely in terms of value and functionality with other more sophisticated smoke evacuation systems. Further, because the device does not utilize the working channel of the trocar sleeve, it does seem a worthwhile expenditure for those who use suction or an irrigator to evacuate their plume.

Value Score: 3.5

Summary

Whether the surgical-plume health hazard is real or theoretical can be argued. The risks to operating room staff from surgical smoke are currently unknown. However, for those looking for a means of visually clearing the surgical field without dispersing the plume into the ambient air of the operating room, a smoke evacuator is needed and the SeeClear MAX system cost-effectively fits the bill.

Overall Score: 3.5

SeeClear™ MAX Laparoscopic Smoke Evacuation System (JLJ Medical Devices International, LLC, Eden Prairie, MN). Photo courtesy of JLJ Medical Devices International, LLC.