Quantitative Chemical Analysis of Surgical Smoke Generated During Laparoscopic Surgery With a Vessel-Sealing Device

Gianella, Michele; Hahnloser, Dieter; Rey, Julien; Sigrist, Markus W.

doi:10.1177/1553350613492025

Cited by 33 publications

(33 citation statements)

References 59 publications

(56 reference statements)

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“…Atualmente, estudos têm sido publicados abordando não somente as consequências da queimadura da fumaça para o trabalhador e o risco de explosões nas salas operatórias (22) , mas também estudos que buscam mensurar os compostos da fumaça e os efeitos no organismo humano (5,7,13) . Entretanto, estes estudos ainda não são conclusivos, mas há forte evidência científica dos malefícios para o ser humano, incluindo a toxicidade na mucosa respiratória (1,23) .…”

Section: Discussionunclassified

“…Estudo afirmou que existe risco de câncer para os cirurgiões frente aos HPA gerados pela fumaça cirúrgica, e esse risco correspondeu a 0,1% (7) . Assim como neste estudo, HPA foram encontrados em estudos transversais realizados em diversos países como na Alemanha, Suécia, Reino Unido e na Suíça, incluindo cirurgias abertas e videolaparoscópicas (5,(13)(14)(15) .…”

Section: Discussionunclassified

“…Essa fumaça cirúrgica é formada por vapor de água e compostos químicos (5)(6) , incluindo os hidrocarbonetos policíclicos aromáticos (HPA) e os óxidos de carbono (5,(7)(8) . Também podem existir microorganismos na fumaça como o Mycobacterium tuberculosis e o vírus da imunodeficiência humana (HIV) ocasionado risco de infecção ainda não mensurado (6,9) .…”

Section: Introductionunclassified

“…O referido composto foi encontrado na fumaça do eletrocautério em estudos internacionais (5,(13)(14)(15) , entretanto ainda são escassos estudos, principalmente nacionais, que abordam a presença dos compostos químicos na fumaça cirúrgica (16) , além daqueles que correlacionem o tempo de uso do eletrocautério e o tempo cirúrgico.…”

Section: Introductionunclassified

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Hidrocarbonetos Policíclicos Aromáticos: Correlação Entre Tempo De Uso Do Eletrocautério E Tempo Cirúrgico

Okubo

Ribeiro²,

Martins³

et al. 2017

Cogitare Enferm.

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RESUMO: Objetivou-se identificar concentrações de hidrocarbonetos policíclicos aromáticos provenientes da fumaça do eletrocautério nas salas operatórias, correlacionando estas concentrações com o tempo de uso do eletrocautério e cirúrgico. Trata-se de um estudo de campo, transversal e quantitativo, realizado em 50 atos cirúrgicos do aparelho digestivo, entre abril e julho de 2015, em hospital The objective was to identify concentrations of polycyclic aromatic hydrocarbons produced by electrocautery smoke in operating rooms, correlating these concentrations with time of electrocautery and surgical use. This is a cross-sectional and quantitative field study carried out in 50 gastrointestinal surgical procedures, between April and July 2015, in a university hospital in the state of Paraná. Hydrocarbons were collected using a suction pump and measurements were determined through liquid chromatography. These compounds were found to have an average of 0.0058 mg.m -3 and a mean of 0.0049 mg.m -3. The mean surgical time and electrocautery use were 136 minutes and 220.5 seconds, respectively. The Spearman correlation test was -0.512 between concentration variables and surgical time, and -0.183 between the concentrations and electrocautery use. The conclusion was the presence of hydrocarbons and a low correlation between the production of these compounds and the electrocautery usage time. DESCRIPTORS: Occupational exposure; Occupational air pollutants; Electrosurgery; Protective devices. Se objetivó identificar concentraciones de hidrocarburos policíclicos aromáticos derivados del humo del electrocauterio en quirófanos, correlacionando las concentraciones con el tiempo de uso del electrocauterio y quirúrgico. Estudio de campo, transversal, cuantitativo, realizado en 50 actos quirúrgicos del aparato digestivo, entre abril y julio de 2015, en hospital universitario del estado de Paraná. Fueron recolectados hidrocarburos mediante una bomba de succión, y determinados por cromatografía líquida. Los compuestos fueron encontrados con promedio de 0,0058 mg.m3 y mediana de 0,0049 mg.m3. El tiempo promedio quirúrgico y de uso del electrocauterio fue de 136 minutos y 220,5 segundos respectivamente. El test de correlación de Spearman fue de -0,512 entre variables concentraciones y tiempo quirúrgico, y de -0,183 entre las concentraciones y tiempo de uso del electrocauterio. Se concluye en que existen hidrocarburos y hay baja correlación entre la producción de tales compuestos y tiempo de uso del electrocauterio.

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Section: Discussionunclassified

Section: Introductionunclassified

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Hidrocarbonetos Policíclicos Aromáticos: Correlação Entre Tempo De Uso Do Eletrocautério E Tempo Cirúrgico

Okubo

Ribeiro²,

Martins³

et al. 2017

Cogitare Enferm.

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“…Surgical smoke inhalation is a known respiratory irritant and experience in an OR confirms its noxious odor [7,11]. There are a number of studies published examining the content of surgical smoke created by these devices [4,11,[17][18][19][20][21][22][23][24][25][26]. Electrocautery dissection of tissue releases airborne hydrocarbons, nitriles, fatty acids, and phenols [3].…”

Section: Introductionmentioning

confidence: 99%

`The air that we breathe¿: assessment of laser and electrosurgical dissection devices on operating theater air quality

Brace

Stevens

Taylor

et al. 2014

J Otolaryngol - Head Neck Surg

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Objectives: To measure changes in air quality during surgery.Methods: Operating room (OR) and hallway air quality was continuously monitored over a 3-month period. Rooftop monitoring was used to control for environmental changes and to account for the infiltration of outdoor air pollutants. Air quality measurements were correlated with operative times and electro-dissection equipment used.Results: OR air is cooler and drier compared to the adjacent hallway. Volatile organic compounds and other gases are below indoor air exposure limit guidelines. Lasers create greater 2.5 μm particulate matter (PM 2.5 ) mass concentration, and greater fine and coarse particle number than cautery or cold tissue dissection. Cautery produces more ultrafine particles (UFP) than other dissection techniques. OR air has lower particle counts than outdoor environmental air by virtue of air conditioning HEPA filtration. Conclusion:Compared to the outside air, operating room air has lower particle counts. Lasers produce higher concentrations of PM 2.5 mass and, fine and coarse particle number counts. Cautery produces higher concentrations of UFP number counts than other modalities and warrants consideration of the use of masks with ultrafine particle filtration capacity. Operating room air is consistently cooler with decreased humidity, which may cause airway irritation.

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Surgical Smoke Exposure in Operating Room Personnel

2019

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t is widely accepted that inhalation of smoke, specifically, the particulate matter (PM) found within smoke, can cause adverse effects on health. When diathermy devices, such as electrocauterization instruments, lasers, and ultrasonic scalpels, are used during surgery, surgical smoke, also called cautery smoke, surgical plume, laser plume, and diathermy plume, is released into the ambient environment. This process occurs in open surgery as well as laparoscopic surgery, as ports are often vented into the atmosphere. There is a lack of studies regarding the long-term effects of surgical smoke; findings from such studies may inform methods to prevent adverse outcomes on the health of operating room personnel. There are several other forms of smoke that the general population encounters, including secondhand smoke, cooking smoke, and environmental pollution. There have been more in-depth studies on these forms of smoke than of surgical smoke, and they can help bolster the present knowledge of the danger of surgical smoke.Although smoke evacuation devices exist, they are not often used in practice owing to inconvenience and lack of awareness. A study done in 2016 reported that 14% of operating room personnel always used local exhaust ventilation during electrosurgery. 1 These respon-dents were also more likely to report training and employer standard procedures regarding the hazards of surgical smoke. The largest difference in consistent use of local exhaust ventilation was attributed to knowledge and training on the hazards of surgical smoke. 1 Most operating room staff acknowledge adverse symptoms (eg, coughing, headache) from surgical smoke, yet few wear effective personal protection. 2 Although multiple health organizations, such as the Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health, have created guidelines regarding exposure to surgical smoke, no laws mandate that protective measures be taken. 3,4 However, there has been increasing research and awareness of the harmful effects of surgical smoke on operating room personnel, leading to a push to increase regulation of surgical smoke exposure, for example, in the California legislature. 5 Signs regarding the dangers of surgical smoke can be found outside the operating room. 6 The medical community is becoming more sensitive to the possible hazards of surgical smoke exposure. 7 While emphasizing the importance of using current evacuation techniques is important, there are new modalities that could improve smoke evacuation beyond the simple vacuum and filter system. IMPORTANCE Smoke generated during surgical procedures has long been thought to be hazardous to hospital personnel; however, the degree of danger has yet to be determined.OBSERVATIONS The dangers of surgical smoke are associated with the composition of the plume. Small-particulate matter is found in the smoke that is easily inhaled. Particulates deposit in the lungs, circulatory system, and other organs, which may cause numerous health problems....

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Quantitative Chemical Analysis of Surgical Smoke Generated During Laparoscopic Surgery With a Vessel-Sealing Device

Cited by 33 publications

References 59 publications

Hidrocarbonetos Policíclicos Aromáticos: Correlação Entre Tempo De Uso Do Eletrocautério E Tempo Cirúrgico

Hidrocarbonetos Policíclicos Aromáticos: Correlação Entre Tempo De Uso Do Eletrocautério E Tempo Cirúrgico

`The air that we breathe¿: assessment of laser and electrosurgical dissection devices on operating theater air quality

Surgical Smoke Exposure in Operating Room Personnel

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