Surgical smoke is generated by energy-based surgical instruments, and all staff and patients are potentially exposed to it in the operating theatre environment. The components of surgical smoke include water and chemicals, with potential bacterial and viral transmission also described. Surgical smoke inhalation has been associated with respiratory tract symptoms, as well as possible infective and carcinogenic risk. Existing guidance recommends appropriate personal protection and adequate ventilation as best practice against this occupational hazard.
Learning objectivesTo identify the sources and components of surgical smoke.To raise awareness of the potential health risks associated with surgical smoke exposure. To educate in risk-reducing strategies and practices.
Ethical issuesPractitioners need to be made aware of the health risks associated with surgical smoke. Employers have a health and safety duty to provide safe systems of work. Occupational health hazards and their prevention should be a component of formal training.
Evidence to support prolonged catheterisation after radical hysterectomy is lacking. We sought to assess feasibility of a new protocol of early post-operative catheter removal following laparoscopic radical hysterectomy for cervical cancer. A retrospective review of post-operative bladder care in patients who underwent laparoscopic radical hysterectomy for cervical cancer was carried out. The post-operative bladder care protocol recommended catheter removal after 24-72 hours. Three consecutive post-void residual scans of less than 150 millilitres (ml) were considered evidence of normal voiding function. First line management of voiding dysfunction was clean intermittent self-catheterisation (CISC). Ninety-eight patients underwent laparoscopic radical hysterectomy for cervical cancer of whom 78 patients had catheter removal 24-72 hours post-operatively. The incidence of post-operative voiding dysfunction in this group was 44%, of whom 88% were managed with CISC and 82% regained normal voiding function. Average hospital stay was 4.2 days. The overall rate of long-term voiding dysfunction was 6%. Early catheter removal after laparoscopic radical hysterectomy appears to be both feasible and effective and compliments the ethos of enhanced patient recovery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.