Transmission Possibility of COVID-19 via Surgical Smoke Generated by the Use of Laparoscopic Approaches: A Subject of Debate During the Pandemic

Abstract

Background: The smoke created by energy-based devices during surgery may have the potential to transmit viral components to operating room staff. The COVID-19 pandemic has changed staff safety regulations. However, it is not clearly understood whether it can be transmitted via surgical smoke. Laparoscopic approaches have become the standard surgical procedure in many cases, but some of previous investigations have advised to pretermit these approaches due to high risk of COVID-19 transmission. Materials and Methods: We reviewed the English literature that were indexed in the PubMed, Google Scholar, and Scopus databases by using key words including Virus, viral transmission, surgical smoke, surgical plum, laparoscopy, and COVID-19 both solely and in two-word combination. A total of 87 articles were found relevant, and after reviewing the abstract, 33 articles were shortlisted and summarized. Results: Previous studies have focused on different surgical instruments that generate smoke, methods to collect and analyze the smoke and to understand the implications of its exposure after an analysis. A total of 9 out of 11 studies on the potential transmission of human papilloma virus through surgical smoke found evidence in favor of transmission. There were studies on the possible transmission of HIV, hepatitis B virus, and Sabin poliomyelitis vaccine virus 2. Conclusion:We do not believe that laparoscopic procedures may have extra risk for COVID-19 transmission compared with the open procedures, but it is always advised that the operating room staff adhere to the safety instructions during the COVID-19 pandemic.

Investigation of Surgical Smoke Exposure and Well-Being Levels of Operating Room Workers in the COVID-19 Pandemic

“…The COVID-19 Pandemic has rekindled these concerns about the presence of the COVID-19 virus and the possibility of transmission to surgical personnel during coagulation devices. So far, there have been no reports of the presence of the COVID-19 virus in surgical smoke, and the contagious potential, if found, is unknown [23].…”

Investigation of Surgical Smoke Exposure and Well-Being Levels of Operating Room Workers in the COVID-19 Pandemic

“…The COVID-19 Pandemic has rekindled these concerns about the presence of the COVID-19 virus and the possibility of transmission to surgical personnel during coagulation devices. So far, there have been no reports of the presence of the COVID-19 virus in surgical smoke, and the contagious potential, if found, is unknown [23].…”

COVID‑19‑associated acute appendicitis in adults. A report of five cases and a review of the literature

“…There is no available evidence to indicate that COVID-19 is transmitted by surgical smoke ( 26 , 27 ). However, it has been reported that as the novel coronavirus has a structure that is comparable to viruses that have been reported to be transmitted by surgical smoke, such as Corynebacterium , human papillomavirus, poliovirus, human immunodeficiency virus and hepatitis B virus, there is a potential danger of viral transmission.…”

The Future in Standards of Care for Gynecologic Laparoscopic Surgery to Improve Training and Education

“…The COVID-19 pandemic imposed specific recommendations/standards related to the perioperative management for gynecologic laparoscopy, such as preoperative screening and testing, with subsequent preprocedure quarantine, online follow-up, and psychological support [58][59][60]. Even if only the possible transmission of HIV, hepatitis B virus, and Sabin poliomyelitis vaccine virus 2 [80]-not SARS-CoV-2 [81]-were reported during minimally invasive surgery, recommendations include filtration for peritoneum and smoke evacuation, and minimizing the use of energy devices and operative staff exposure, including special personal protection equipment [57][58][59]82,83].…”

Investigation of Surgical Smoke Exposure and Well-Being Levels of Operating Room Workers in the COVID-19 Pandemic

“…The COVID-19 Pandemic has rekindled these concerns about the presence of the COVID-19 virus and the possibility of transmission to surgical personnel during coagulation devices. So far, there have been no reports of the presence of the COVID-19 virus in surgical smoke, and the contagious potential, if found, is unknown [23].…”

COVID‑19‑associated acute appendicitis in adults. A report of five cases and a review of the literature

“…There is no available evidence to indicate that COVID-19 is transmitted by surgical smoke ( 26 , 27 ). However, it has been reported that as the novel coronavirus has a structure that is comparable to viruses that have been reported to be transmitted by surgical smoke, such as Corynebacterium , human papillomavirus, poliovirus, human immunodeficiency virus and hepatitis B virus, there is a potential danger of viral transmission.…”

The Future in Standards of Care for Gynecologic Laparoscopic Surgery to Improve Training and Education

“…The COVID-19 pandemic imposed specific recommendations/standards related to the perioperative management for gynecologic laparoscopy, such as preoperative screening and testing, with subsequent preprocedure quarantine, online follow-up, and psychological support [58][59][60]. Even if only the possible transmission of HIV, hepatitis B virus, and Sabin poliomyelitis vaccine virus 2 [80]-not SARS-CoV-2 [81]-were reported during minimally invasive surgery, recommendations include filtration for peritoneum and smoke evacuation, and minimizing the use of energy devices and operative staff exposure, including special personal protection equipment [57][58][59]82,83].…”

Investigation of Surgical Smoke Exposure and Well-Being Levels of Operating Room Workers in the COVID-19 Pandemic

“…The COVID-19 Pandemic has rekindled these concerns about the presence of the COVID-19 virus and the possibility of transmission to surgical personnel during coagulation devices. So far, there have been no reports of the presence of the COVID-19 virus in surgical smoke, and the contagious potential, if found, is unknown [23].…”

COVID‑19‑associated acute appendicitis in adults. A report of five cases and a review of the literature

“…There is no available evidence to indicate that COVID-19 is transmitted by surgical smoke ( 26 , 27 ). However, it has been reported that as the novel coronavirus has a structure that is comparable to viruses that have been reported to be transmitted by surgical smoke, such as Corynebacterium , human papillomavirus, poliovirus, human immunodeficiency virus and hepatitis B virus, there is a potential danger of viral transmission.…”

The Future in Standards of Care for Gynecologic Laparoscopic Surgery to Improve Training and Education

“…The COVID-19 pandemic imposed specific recommendations/standards related to the perioperative management for gynecologic laparoscopy, such as preoperative screening and testing, with subsequent preprocedure quarantine, online follow-up, and psychological support [58][59][60]. Even if only the possible transmission of HIV, hepatitis B virus, and Sabin poliomyelitis vaccine virus 2 [80]-not SARS-CoV-2 [81]-were reported during minimally invasive surgery, recommendations include filtration for peritoneum and smoke evacuation, and minimizing the use of energy devices and operative staff exposure, including special personal protection equipment [57][58][59]82,83].…”