The Double Pump RF is one of the most advanced and high-tech arthroscopy pumps on the market. The reason for using a pump in an arthroscopic procedure is to:
SmartVision is a patented technology owned by Insightra, which automatically adjusts the pressure and flow when blood or debris is detected. The SmartVision function consists of an optical detector located behind the Patient Cassette. Through deviation of LED light the detector can differentiate between blood and debris and adjust fluid pressure and flow rate accordingly. When the sensor detects blood, both the pressure and flow is increased in steps. When the bleeding stops and the blood is flushed out of the joint, the pressure and flow gradually decreases to its original setting. If the sensor detects debris, the flow is increased, until the surgeon again has a clear field of vision.
The Double Pump RF has the ability to communicate with a RF generator, allowing optimal pressure and flow settings during ablation in the joint. The Double Pump RF controls both the in- and out-flow and consequently both pressure and flow. The pump operates through usage of disposable slide-in tubing cassettes, one cassette which controls the in-flow (Day Cassette, used for one surgical day) and one that controls the out-flow (Patient Cassette, new for every patient). The key advantages of using the Double Pump are:
The fluid used is saline which is administrated through two types of cassettes, a “Patient” and a “Day” cassette. The Day cassette is used for one surgical day and transports the fluid from the sterile saline bag via the pump to the joint, where it connects to the arthroscope sheath. The Patient cassette then transports the contaminated fluids from the joint, through an outflow cannula, via the pump and into a waste dispenser. However, today some surgeons exclude the usage of separate outflow channel (via the disposable cannula). Instead evacuation of irrigated fluids is made through the working port or through the Shaver (if the function “Shaver suction” is available on the pump). There are also examples where the evacuation is made through the arthroscopic sheath (a so-called double sheath). Neither of these alternatives to the disposable outflow cannula is efficient when it comes to visibility, which is most often compromised due to bad fluid management performance when a proper evacuation port is excluded. The evacuation issue is one of most important areas of improvement to reach a problematic-free arthroscopic procedure with maximum visibility.
Clinically the benefits of SmartVision are many. Firstly, the fact that the pressure in the joint can be held on an optimal, low level at any time during the procedure means that less fluids are used and diffusion of saline to surrounding tissue can be avoided. Secondly, the procedure time can be shortened by as much as 15%. Furthermore, since the average pressure used is much lower compared to other pumps, a procedure can continue for longer times than normal, without any problems for the patient. In fact, usage of the Double Pump with the SmartVision function will be less invasive for the patient and reduce recovery times1.
SmartVision is one of the latest advancements in the fluid management field, which positions Insightra as technology leader in the fluid management segment in arthroscopy.
Outflow Tracking is another unique function of the Double Pump. The main purpose of this function is to assist in keeping the joint distended when adjusting outflow rapidly (e.g. when using Rinse/Lavage mode or when using a Shaver).
This function ensures that the same amount of fluid gets in and out of the joint at any given moment. The Outflow Tracking function changes the primary criteria for the pump from pressure to volume. This means that the pressure can sometime decrease when using this function for a long period of time. In order to get the most out of this function, it is suggested that a high-flow sheath is used.
1 Data on file - Medical Vision AB (Medical Vision AB is a subsidiary of Insightra Medical Inc.)