An airstream isolation system provides stable insufflation of the rectum and continuous smoke evacuation during transanal endoscopic surgery (TES).

The SurgiQuest AirSeal System is an integrated platform that provides valve-free trocar access and insufflation to the operative cavity, even when energized medical devices, such as electrocautery, laser, or ultrasound systems are used. The system continuously and automatically evacuates smoke and plume, while simultaneously and continuously evacuating, filtering, and recirculating CO2, thus providing high a stable pneumoperitoneum—even under constant suction—and continuous smoke evacuation throughout the procedure.

The AirSeal access port features a proprietary 3-channel intake manifold designed to maximize inflow, evacuate smoke, and enable continuous pressure sensing. It also features a unique means of creating a seal by using a series of high pressure nozzles within the cannula housing that directs a downward pressure of CO2 that is equal in force to the intra-abdominal pressure chosen by the surgeon. The result is an invisible, horizontal air barrier that instantaneously responds to changes in pressure, either by allowing more CO2 inflow with pressure drops or by serving as a pressure relief valve during pressure spikes.

The software driven system features a large touch screen display that enables monitoring of key readouts, including flow rate, pressure, and gas supply level. Visual and audible alerts communicate important messages to the operating room (OR) team, including low gas level warnings or excessive flow alerts which may indicate an open stopcock or a dislodged trocar. Three different operating modes are available, depending on the specific needs of the procedure. The SurgiQuest AirSeal System is a product of SurgiQuest (Milford, CT, USA).

“The AirSeal Platform is a key factor in performing an ideal transanal minimally invasive surgery procedure,” said Joep Knol, MD, a colorectal surgeon in Belgium and the first to use the AirSeal System in a TES approach. “By achieving a stable pneumorectum and providing optimal smoke evacuation, a meticulous dissection is possible.”

TES includes both transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (TaTME), a surgical technique that has been shown to significantly improve patient outcomes in colorectal cancer procedures.

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