Do we need to reduce surgical smoke?

Abstract

Surgical smoke has become a topic of interest recently. Nine states in the United States have considered bills to reduce surgical smoke, and three states (Rhode Island, Colorado, and Kentucky) have enacted laws regarding surgical smoke in the last 5 years (1). These laws have been advocated for by the Association of periOperative Registered Nurses (AORN) and The Joint Commission (1). The Joint Commission published, "Alleviating the dangers of surgical smoke" as a Quick Safety report in 2020 (2). The AORN has created the "Go Clear Award TM Program" which gives awards to facilities that have sufficient surgical smoke evacuators/accessories, and comply with use (3). Both the AORN and The Joint Commission have published the potential hazards from surgical smoke, asserting, "research studies confirm that the surgical smoke plume can contain toxic gases and vapors…bioaerosols, dead and live cellular material (including blood fragments), and viruses" (1).Given that centers which provide surgical services are encouraged (and in some states mandated) to mitigate exposure of operating room staff to surgical smoke, there is a market need for this type of equipment. Medtronic, the medical device company that sponsors the AORN Go Clear Award TM Program, also sells smoke evacuator electrocautery pencils, smoke evacuator systems (4), and electrosurgical systems that function at lower temperature and reduce surgical smoke production (5). As such, Zhang et al. recently reported their analysis of a new surgical device called the NTS-100, which functions by pulsed radiofrequency energy at a lower temperature than traditional electrocautery (5).