Objectives: The aim of this study was to assess the exposure of patients to organic substances produced and identified in surgical smoke formed in the abdominal cavity during laparoscopic cholecystectomy. Material and Methods: Identification of these substances in surgical smoke was performed by the use of gas chromatography-mass spectrometry (GC-MS) with selective ion monitoring (SIM). The selected biomarkers of exposure to surgical smoke included benzene, toluene, ethylbenzene and xylene. Their concentrations in the urine samples collected from each patient before and after the surgery were determined by SPME-GC/MS. Results: Qualitative analysis of the smoke produced during laparoscopic procedures revealed the presence of a wide variety of potentially toxic chemicals such as benzene, toluene, xylene, dioxins and other substances. The average concentrations of benzene and toluene in the urine of the patients who underwent laparoscopic cholecystectomy, in contrast to the other determined compounds, were significantly higher after the surgery than before it, which indicates that they were absorbed. Conclusions: The source of the compounds produced in the abdominal cavity during the surgery is tissue pyrolysis in the presence of carbon dioxide atmosphere. All patients undergoing laparoscopic procedures are at risk of absorbing and excreting smoke by-products. Exposure of the patient to emerging chemical compounds is usually a one-time and short-term incident, yet concentrations of benzene and toluene found in the urine were significantly higher after the surgery than before it.

Objectives: During laparoscopic cholecystectomy, the removal of the gall bladder, pyrolysis occurs in the peritoneal cavity. Chemical substances which are formed during this process escape into the operating room through trocars in the form of surgical smoke. The aim of this study was to identify and quantitatively measure a number of selected chemical substances found in surgical smoke and to assess the risk they carry to medical personnel. Material and Methods: The study was performed at the Maria Skłodowska-Curie Memorial Provincial Specialist Hospital in Zgierz between 2011 and 2013. Air samples were collected in the operating room during laparoscopic cholecystectomy. Results: A complete qualitative and quantitative analysis of the air samples showed a number of chemical substances present, such as aldehydes, benzene, toluene, ethylbenzene, xylene, ozone, dioxins and others. Conclusions: The concentrations of these substances were much lower than the hygienic standards allowed by the European Union Maximum Acceptable Concentration (MAC). The calculated risk of developing cancer as a result of exposure to surgical smoke during laparoscopic cholecystectomy is negligible. Yet it should be kept in mind that repeated exposure to a cocktail of these substances increases the possibility of developing adverse effects. Many of these compounds are toxic, and may possibly be carcinogenic, mutagenic or genotoxic. Therefore, it is necessary to remove surgical smoke from the operating room in order to protect medical personnel.

Unusual clinical course Background:Intra-abdominal impalement injuries caused by a penetrating foreign body are rare and often fatal. The mechanism of injury is usually associated with vascular and organ damage, and the course is dynamic, with high morbidity and mortality. Post-traumatic presence of glass pieces in the peritoneal cavity after an old impalement injury is rare. Case Report:A 52-year-old woman sustained a 4-cm laceration in her lumbar region after falling on a glass table that shattered. After a physical examination and wound exploration in the emergency room, no foreign body was found.The laceration was sutured without X-ray imaging. She was admitted to the Surgical Department 9 months later for diagnosis of lower abdominal pain. In a CT scan of the abdominal cavity, a 19-cm fragment of glass was found intraperitoneally, inter-looped in the pelvic cavity. A laparotomy was performed, during which the foreign body was found and removed. No abdominal organs were injured. Further outpatient treatment was normal. Conclusions:Potentially minor abdominal impalement injuries can cause serious organ damage. Every patient, even if asymptomatic, and even after trivial injury with a small skin wound, must be suspected of having a hidden foreign body. Accurate visual, manual, and instrumental wound exploration is always necessary. Imaging exams are an important diagnostic method when the presence of a post-traumatic foreign body is suspected.

Captopril content was determined in real urine samples delivered from patients treated with this drug.

Damage to the thyroid due to blunt neck injury is rare. About half of the described cases occurred in the thyroid with pathological changes. They are usually associated with large hematomas of the neck that cause respiratory failure. We present a case of a patient whose thyroid injury caused rupture of the left thyroid lobe with a hematoma of the mediastinum and right pleural cavity.