With the development of modern medical technology, minimally invasive surgery has been widely carried out in clinic. As one of the endoscopes, laparoscopic surgery has become an important part of minimally invasive surgery. Clear surgical field is the key to the safety of laparoscopic surgery, so the antifogging treatment of endoscopic lens is very important. In endoscopic surgery, due to the great difference between the body cavity temperature and the external temperature, some water vapor is easy to condense and form a layer of mist after encountering the cold endoscope, which affects the clarity of the surgical site. Display and influence operation. For many years, the traditional lens preheating method has been used in clinical practice for antifogging treatment. However, in practice, salt water spraying, scalding and lens capsizing often occur, which increase the chance of intraoperative contamination and lens damage.

鏡頭總是模糊。反復(fù)擦拭鏡頭會浪費(fèi)很多時(shí)間，并且還會帶來不安全因素。這就要求眼鏡助手應(yīng)善于快速處理鏡片起霧和污染問題，并盡可能長時(shí)間保持視野清晰。

The lens is always blurry. Repeatedly wiping the lens will waste a lot of time, and will also bring insecurity. This requires that the glasses assistant should be good at dealing with lens fogging and pollution quickly, and keep the vision clear for as long as possible.

內(nèi)窺鏡頭起霧和污染怎么辦？專家答疑：

How to deal with fog and pollution of endoscope lens? Expert answers:

（1）購置帶鏡頭自加熱的腔鏡設(shè)備，但大部分品牌無此功能；

(1) Buy the cavity mirror equipment with lens self heating, but most brands do not have this function;

（2）鏡頭涂抹防霧劑，價(jià)格貴、成本高；

(2) The lens is coated with antifogging agent, which is expensive and costly;
                   

（3）碘伏紗布擦拭，成本較低，視野易發(fā)黃；

(3) Iodophor gauze wipe, low cost, easy to yellow vision;

（4）將鏡頭回縮至 Trocar內(nèi)，利用鏡頭 Trocar 內(nèi)注入的相對低溫的 CO2 氣流使視野變清晰，但易反復(fù)；

(4) The lens is retracted into the trocar, and the relatively low temperature CO2 gas injected into the trocar makes the field of vision clear, but it is easy to repeat;

（5）消毒保溫杯裝熱水浸泡鏡頭，水溫保持在60 ～ 70℃，

(5) The lens was soaked in hot water in sterilized heat preservation cup, and the water temperature was kept at 60-70 ℃,

一次浸泡鏡頭時(shí)間要稍長，約 1 分鐘，好讓鏡頭充分預(yù)熱，高于腹腔內(nèi)溫度。此后，每次鏡頭模糊后浸泡時(shí)間僅需幾秒即可。此法過程較為繁瑣。

Soak the lens a little longer, about 1 minute, so that the lens fully preheat, higher than the temperature in the abdominal cavity. After that, the soaking time only takes a few seconds after each blur. This method is complicated.

另外每次置入鏡頭前需將的密封墊內(nèi)的組織或血液清理干凈，可以通過旋轉(zhuǎn)鏡身來避開 Trocar下端的血液；進(jìn)出動作要迅速，避免鏡身在體外太久而降溫。

In addition, the tissue or blood in the sealing pad should be cleaned before each lens placement, and the blood at the lower end of trocar can be avoided by rotating the lens body; Move in and out quickly to prevent the mirror body from cooling down for too long.

當(dāng)急性大出血污染內(nèi)窺鏡鏡頭時(shí)，切不可拔出鏡頭擦拭，這樣可能會錯(cuò)失處理的好時(shí)機(jī)，此時(shí)可以借助臟器漿膜面（多選擇未被污染的胃、腸漿膜面）快速而輕柔地擦拭鏡頭。不要選擇系膜或網(wǎng)膜表面，可能使內(nèi)窺鏡鏡頭沾染油脂而更加模糊；也不要選擇肝臟或脾臟這類實(shí)質(zhì)性臟器，防止損傷。當(dāng)術(shù)者解決出血后，扶鏡手應(yīng)重新擦拭內(nèi)窺鏡鏡頭。

When the endoscopic lens is polluted by acute massive hemorrhage, the lens must not be pulled out to wipe, which may miss a good opportunity for treatment. At this time, the lens can be wiped quickly and gently with the help of the serosa surface of the organs (mostly the surface of the gastric and intestinal serosa that is not polluted). Do not choose the surface of mesangium or omentum, which may make the endoscope lens stained with grease and more blurred; Do not choose the liver or spleen such as solid organs, to prevent injury. When the bleeding is solved, the hand should wipe the lens again.

為了使操作過程順暢，內(nèi)窺鏡手應(yīng)盡量少擦拭內(nèi)窺鏡鏡頭。這就要求眼鏡助手總是保護(hù)鏡片。例如，當(dāng)能量平臺為刀頭燒灼時(shí)，應(yīng)適當(dāng)縮回內(nèi)窺鏡鏡頭以避免遙測，以防止組織液或血液飛濺到鏡頭上，并在燒灼完成后返回到原始視距。內(nèi)窺鏡手的任務(wù)是為手術(shù)者提供清晰穩(wěn)定的手術(shù)圖像。并且隨著手術(shù)過程的變化，它提供了遠(yuǎn)近范圍和角度的適當(dāng)視野。換句話說，戴眼鏡的手充當(dāng)術(shù)者的“兩只眼睛”。這就要求腹腔鏡手必須熟悉手術(shù)步驟和術(shù)者的手術(shù)習(xí)慣，并且必須用手術(shù)者保持足夠的默契。

In order to make the operation process smooth, the endoscope hand should wipe the endoscope lens as little as possible. This requires the glasses assistant to always protect the lenses. For example, when the energy platform cauterizes the blade, the endoscope lens should be retracted appropriately to avoid telemetry, so as to prevent tissue fluid or blood splashing on the lens, and return to the original visual range after cauterization. The task of the endoscopic hand is to provide a clear and stable image for the surgeon. And with the change of the operation process, it provides an appropriate field of vision of the far and near range and angle. In other words, the hand with glasses acts as the surgeon's "two eyes.". This requires that the laparoscopic hand must be familiar with the operation procedure and the operator's operation habits, and must keep enough tacit understanding with the operator.