Low‐cost, safe, and effective smoke evacuation device for surgical procedures in the COVID‐19 age

Andrade, Wesley Pereira; Gonçalves, Graziella Galvão; Medeiros, Luciana Cortelazzi; Araujo, Danielle Cristina Miyamoto; Pereira, Gisele Tolaini Gomes; Moraes, Daniela Martins Pereira; Spencer, Ranyell M.S.S.B.

doi:10.1002/jso.26133

Cited by 6 publications

(2 citation statements)

References 10 publications

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“…One of the other disadvantages of surgical smoke is that it can significantly impair vision of the surgical field during some open and laparoscopic surgery. 41,42 Importantly, smoke evacuation devices help to reduce the time that vision of the surgical field is impaired and may reduce the overall operating time. Consequently, these objections are not sufficient to outweigh the short- and long-term benefits that could be accrued by pre-emptively and effectively removing surgical smoke at the site of surgery.…”

Section: Objections To Surgical Smoke Evacuation Systems Usementioning

confidence: 99%

The case for compulsory surgical smoke evacuation systems in the operating theatre

Cooper

2021

Clinical Ethics

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Perioperative staff are frequently exposed to surgical smoke or plume created by using heat-generating devices like diathermy and lasers. This is a concern due to mounting evidence that this exposure can be harmful with no safe level of exposure yet identified. First, I briefly summarise the problem posed by surgical smoke exposure and highlight that many healthcare organisations are not sufficiently satisfying their legal and ethical responsibilities to protect their staff from potential harm. Second, I explore the ethical case for compulsory smoke evacuation systems using the principlist framework and its four ethical principles – autonomy, beneficence, nonmaleficence, and justice. I then consider some objections and argue that surgical smoke evacuation systems – when indicated – should be made compulsory.

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Section: Objections To Surgical Smoke Evacuation Systems Usementioning

confidence: 99%

The case for compulsory surgical smoke evacuation systems in the operating theatre

Cooper

2021

Clinical Ethics

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“…This is aligned with surgical societies that have advocated for the use of dedicated smoke evacuation units in open and laparoscopic procedures [36][37][38][39] . Multiple studies have found that adopting smoke evacuation systems can effectively reduce contaminants in a cost-efficient manner 40,41 . Additionally, smoke evacuation technologies also have a strategic advantage over traditional personal protective equipment (PPE), which can be insufficient to prevent exposure to surgical aerosols generated which may be inhaled with smoke 42 .…”

Section: Introductionmentioning

confidence: 99%

A device category economic model of electrosurgery technologies across procedure types: a U.S. hospital budget impact analysis

Ferko

Wright

Syed

et al. 2021

Journal of Medical Economics

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Aims:The electrosurgical technology category is used widely, with a diverse spectrum of devices designed for different surgical needs. Historically, hospitals are supplied with electrosurgical devices from several manufacturers, and those devices are often evaluated separately; it may be more efficient to evaluate the category holistically. This study assessed the health economic impact of adopting an electrosurgical device-category from a single manufacturer. Methods: A budget impact model was developed from a U.S. hospital perspective. The uptake of electrosurgical devices from EES (Ethicon Electrosurgery), including ultrasonic, advanced bipolar, smoke evacuators, and reusable dispersive electrodes were compared with similar MED (Medical Energy Devices) from multiple manufacturers. It was assumed that an average hospital performed 10,000 annual procedures 80% of which involved electrosurgery. Current utilization assumed 100% MED use, including advanced energy, conventional smoke mitigation options (e.g. ventilation, masks), and single-use disposable dispersive electrode devices. Future utilization assumed 100% EES use, including advanced energy devices, smoke evacuators (i.e. 80% uptake), and reusable dispersive electrodes. Surgical specialties included colorectal, bariatric, gynecology, thoracic and general surgery. Systematic reviews, network meta-analyses, and meta-regressions informed operating room (OR) time, hospital stay, and transfusion model inputs. Costs were assigned to model parameters, and price parity was assumed for advanced energy devices. The costs of disposables for dispersive electrodes and smokeevacuators were included. Results: The base-case analysis, which assessed the adoption of EES instead of MED for an average U.S. hospital predicted an annual savings of $824,760 ($101 per procedure). Savings were attributable to associated reductions with EES in OR time, days of hospital stay, and volume of disposable electrodes. Sensitivity analyses were consistent with these base-case findings. Conclusions: Category-wide adoption of electrosurgical devices from a single manufacturer demonstrated economic advantages compared with disaggregated product uptake. Future research should focus on informing comparisons of innovative electrosurgical devices.

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Robotic liver resection in the posterosuperior segments as a way to extent the mini-invasive arsenal: a comparison with transthoracic laparoscopic approach

et al. 2023

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Background The field of robotic liver resection (RLR) has developed in the past decades. This technique seems to improve the access to the posterosuperior (PS) segments. Evidence of a possible advantage over transthoracic laparoscopy (TTL) is not yet available. We aimed to compare RLR to TTL for tumors located in the PS segments of the liver in terms of feasibility, difficulty scoring, and outcome. Methods This retrospective study compared patients undergoing robotic liver resections and transthoracic laparoscopic resections of the PS segments between January 2016 and December 2022 in a high-volume HPB center. Patients’ characteristics, perioperative outcomes, and postoperative complications were evaluated. Results In total, 30 RLR and 16 TTL were included. Only wedge resections were performed in the TTL group, while 43% of the patients in the RLR group had an anatomical resection ( p < 0.001). The difficulty score according to the IWATE difficulty scoring system was significantly higher in the RLR group ( p < 0.001). Total operative time was similar between the two groups. Complication rates, either overall or major, were comparable between the two techniques and hospital stay was significantly shorter in the RLR group. Patients in the TTL group were found to have more pulmonary complications ( p = 0.01). Conclusion RLR may provide some advantages over TTL for the resection of tumors located in the PS segments.

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Low‐cost, safe, and effective smoke evacuation device for surgical procedures in the COVID‐19 age

Cited by 6 publications

References 10 publications

The case for compulsory surgical smoke evacuation systems in the operating theatre

The case for compulsory surgical smoke evacuation systems in the operating theatre

A device category economic model of electrosurgery technologies across procedure types: a U.S. hospital budget impact analysis

Robotic liver resection in the posterosuperior segments as a way to extent the mini-invasive arsenal: a comparison with transthoracic laparoscopic approach

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