Removal of Hazardous Surgical Smoke Using a Built-in-Filter Trocar: A Study in Laparoscopic Rectal Resection

Hahn, Koo Yong; Kang, Dong Woo; Azman, Zairul Azwan Mohd; Kim, Seyoung; Kim, Seon Hahn

doi:10.1097/sle.0000000000000459

Cited by 31 publications

(39 citation statements)

References 17 publications

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“…One previous study tested the efficiency of the same port with a disposable built-in filter to eliminate surgical smoke during laparoscopic rectal resection. 9 Five volatile organic compounds and four aldehydes were detected in surgical smoke, and these were filtered in the range of 33%–72%. Nevertheless, the amount of reduction was not significant for most chemicals including formaldehyde (0.22 to 0.13 ppm, P = .346).…”

Section: Discussionmentioning

confidence: 99%

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Chemicals in Surgical Smoke and the Efficiency of Built-in-Filter Ports

Choi

Jung

et al. 2019

JSLS

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Background and Objectives:Surgical smoke contains various malodorous and hazardous combustion byproducts. We aimed to analyze hydrocarbons accumulated in the abdominal cavity during laparoscopic gynecologic surgery and determine the efficiency of a built-in-filter port.Methods:We prospectively followed seven patients with benign uterine pathology. Surgical smoke was generated using laparoscopic or robotic electrocautery. The smoke was collected twice for each patient using a built-in-filter port and a conventional port. The concentrations of volatile organic compounds and aldehydes were determined using gas chromatography with mass spectrometry and high-performance liquid chromatography with ultraviolet visible light detection and compared using the paired-sample Wilcoxon signed-rank test.Results:Five volatile organic compounds and five aldehydes had toxic effects or unpleasant odors. The median concentration of formaldehyde before filtration (0.870 ppm) exceeded the time-weighted average concentration (0.75 ppm) of the Occupational Safety and Health Administration. Built-in-filter ports significantly reduced the concentration of five volatile organic compounds and two aldehydes but not that of formaldehyde, acetaldehyde, and propionaldehyde. Formaldehyde concentration decreased by 50% after filtration but remained above the recommended exposure limit (0.016 ppm) of the National Institute of Occupational Safety and Health.Conclusions:Surgical smoke in minimally invasive gynecologic procedures contains several hazardous hydrocarbons including formaldehyde. Built-in-filter ports have the potential to reduce the exposure of surgical smoke to surgeons and operating room personnel; nevertheless, development of built-in-filter ports is necessary to improve the filtering efficiency for highly concentrated formaldehydes.

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, only a few studies have evaluated whether the harmful chemicals can be efficiently reduced or the advantages can be provided by the filtering systems installed on ports. 9–11…”

Section: Introductionmentioning

confidence: 99%

Chemicals in Surgical Smoke and the Efficiency of Built-in-Filter Ports

Choi

Jung

et al. 2019

JSLS

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“…Additionally, disposable smoke evacuation hose is one of the most previous ways used in electrosurgery to reduce surgical smoke 89. Elimination of surgical smoke via a disposable built-in-filter trocar has been identified as a simple and effective way to reduce chemical compounds such as benzene, toluene, butyraldehyde, ethylbenzene, xylene, styrene, formaldehyde, and propionaldehyde, to some extent 90.…”

Section: Protective Measures For Gynecologistmentioning

confidence: 99%

Awareness of surgical smoke hazards and enhancement of surgical smoke prevention among the gynecologists

et al. 2019

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Surgical smoke is the gaseous by-product produced by heat generating devices in various surgical operations including laser conization and loop electrosurgical procedures that often are performed by gynecologists. Surgical smoke contains chemicals, blood and tissue particles, bacteria, and viruses, which has been shown to exhibit potential risks for surgeons, nurses, anesthesiologists, and technicians in the operation room due to long term exposure of smoke. In this review, we describe the detailed information of the components of surgical smoke. Moreover, we highlight the effects of surgical smoke on carcinogenesis, mutagenesis, and infection in gynecologists. Furthermore, we discussed how to prevent the surgical smoke via using high-filtration masks and smoke evacuation systems as well as legal guidelines for protection measures among the gynecologists.

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“… finger‐controlled suction devices that gently remove surgical smoke from the peritoneal cavity; low‐pressure suction valves positioned inside the suction line that can be depressed to evacuate plume; passive evacuation devices that can be attached to the trocar sheath, providing a steady release of plume while also filtering surgical smoke to protect the surgical team members from smoke exposure; trocars with built‐in filters that have been shown to be effective at removing harmful by‐products from the gas used to establish the pneumoperitoneum; and special smoke evacuator for specific removal of laparoscopic plume. …”

Section: Surgical Smoke and Patientsmentioning

confidence: 99%