Surgical Endoscopy

, Volume 32, Issue 3, pp 1593–1599 | Cite as

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

  • S. Bendifallah
  • E. Salakos
  • I. Naoura
  • P. Aristizabal
  • E. Furet
  • S. Zilberman
  • M. Ballester
  • E. Darai
New Technology



The FloShield Air System® is a new device for laparoscopic surgery that utilizes a continuous dry CO2 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.


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 < 0.001). No difference in time to clean, quality of vision, level of laparoscopic procedure complexity, or cost was observed between the groups.


The FloShield Air System® resulted in fewer laparoscopic lens removals than the water + PVI solution solution, but that there was no difference in quality of vision, cleaning time or cost, especially for the more complex surgery.


Gynecologic endoscopic surgery Randomized trial Lens vision quality 


Compliance with ethical standards


Drs Bendifallah, Salakos, Naoura, Aristizabal, Furet, Zilberman and Prs Ballester, and Darai have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2017_5642_MOESM1_ESM.doc (241 kb)
Supplementary material 1 (DOC 241 kb)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • S. Bendifallah
    • 1
    • 2
    • 4
  • E. Salakos
    • 1
  • I. Naoura
    • 1
  • P. Aristizabal
    • 1
  • E. Furet
    • 1
  • S. Zilberman
    • 1
  • M. Ballester
    • 1
    • 3
  • E. Darai
    • 1
    • 3
  1. 1.Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Institut Universitaire de Cancérologie (IUC)University Pierre and Marie CurieParis 6France
  2. 2.INSERM UMR_S_707, “Epidemiology, Information Systems, Modeling”University Pierre and Marie CurieParis 6France
  3. 3.UMR_S938 Université Pierre et Marie CurieParis 6France
  4. 4.Service de Gynécologie-ObstétriqueHôpital TenonParisFrance

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