A systematic review of the harmful effects of surgical smoke inhalation on operating room personnel

Dixon, K.; Dasgupta, P.; Vasdev, Nikhil

doi:10.1016/j.hsr.2023.100077

Cited by 4 publications

(3 citation statements)

References 43 publications

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“…Another limitation may be the capabilities of different insufflation devices; many of which are not designed to insufflate with multiple gases such as the Airseal ® iFS or ENDOFLATOR® 50 [ 35 ]. If pre-developed gas mixtures were introduced into the system, issues such as turbulent flow and ineffective smoke evacuation may develop, both of which are problematic due to current COVID-19 guidelines and the increased awareness of the harms of surgical smoke [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Use of mixed gas pneumoperitoneum during minimally invasive surgery: a systematic review of human and mouse modelled laparoscopic interventions

Chen,

Dasgupta,

Vasdev

2024

J Robotic Surg

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The formation of pneumoperitoneum involves the process of inflating the peritoneal cavity during laparoscopic and typically uses CO2 as the insufflation gas. This review aims to identify ideal gas mixtures for establishing the pneumoperitoneum with animal and human studies undertaken up to the writing of this review. A systematic search of PubMed, OVID, and clinicaltrials.gov was performed to identify studies on the utilisation of mixed gases in laparoscopic surgery, including non-randomised/randomised trials, animal and human studies, and studies with inflating pressures between 12 and 16 mmHg. ROBINS-I and RoB2 tool was used to assess the risk of bias. A narrative synthesis of results was performed due to the heterogeneity of the studies. 5 studies from the database search and 5 studies from citation search comprising 128 animal subjects and 61 human patients were found. These studies collated results based on adhesion formation (6 studies), pain scores (2 studies) and other outcomes, with results favouring the use of carbon dioxide + 10% nitrous oxide + 4% oxygen. This has shown a significant reduction in adhesion formation, pain scores and inflammation. The use of this gas mixture provides promising results for future practice. Several of the studies available require larger sample sizes to develop a more definitive answer on the effects of different gas mixtures. Furthermore, the number of confounding factors in randomised trials should be reduced so that each component of the current suggested gas mixture can be tested for safety and efficacy.

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Section: Discussionmentioning

confidence: 99%

Use of mixed gas pneumoperitoneum during minimally invasive surgery: a systematic review of human and mouse modelled laparoscopic interventions

Chen,

Dasgupta,

Vasdev

2024

J Robotic Surg

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“…Although the N95 respirator offers higher filtration efficiency, it requires a proper fit and seal for optimal performance. If an N95 respirator does not fit properly, gaps or leaks can compromise the effectiveness of the respirator and allow hazardous substances to enter the respirator [ 70 ]. Fit testing is critical to ensuring the proper fit of N95 respirators.…”

Section: Reviewmentioning

confidence: 99%

The Impact of Electrocautery Smoke on Surgical Staff and the Efficacy of Normal Surgical Masks Versus N95 Masks

Meretsky,

Mahmoodi,

Knecht

et al. 2024

Cureus

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Electrocautery is a commonly used technique in surgical procedures, generating smoke that poses health risks to surgical staff. This study investigates the comparative efficacy of normal surgical masks versus N95 masks in mitigating the harmful effects of electrocautery smoke. Through a systematic review of literature spanning two decades, we explore the causes and effects of electrocautery smoke exposure, including potential long-term inhalation effects. Our findings highlight significant disparities in the protection offered by different masks and underscore the importance of adequate respiratory protection in surgical settings. In addition, we examine the factors influencing the generation and composition of electrocautery smoke, such as the power settings used, the type of tissue being cauterized, and the duration of the procedure. Furthermore, we discuss the potential health risks associated with long-term exposure to electrocautery smoke, including the possibility of respiratory conditions, cardiovascular effects, and carcinogenicity. Our analysis also addresses the importance of implementing appropriate smoke evacuation systems and optimizing operating room ventilation to minimize the concentration of smoke particles in the surgical environment. Overall, this comprehensive analysis provides valuable insights into the impact of electrocautery smoke in surgical settings and the varying levels of protection offered by different masks.

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“…La electrocirugía, la ablación con láser y la disección con bisturí ultrasónico crean un subproducto gaseoso comúnmente conocido como humo quirúrgico, que constituye un peligro técnico, físico, químico y biológico para el personal de la sala de cirugía. La inhalación de dichas partículas puede traer consecuencias inflamatorias, irritación ocular, lesiones del aparato respiratorio por productos de la destrucción térmica de los tejidos, exposición a mutágenos y carcinógenos o transmisión de patógenos, representando un espectro de efectos adversos asociados con la exposición ocupacional al humo quirúrgico 6,7 .…”

Section: El Humo Quirúrgicounclassified

El humo del electrocauterio, el riesgo olvidado y minimizado de la cirugía

Ensuncho-Hoyos,

Barguil-Fernández de Castro,

Lara-Fortich

et al. 2024

Rev Colomb Cir

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Introducción. La nueva era de la cirugía es cada vez más dependiente de la tecnología, y un ejemplo de ello es el uso generalizado de electrocauterio como parte primordial de la práctica quirúrgica. El humo quirúrgico es un subproducto de la disección y la coagulación de los tejidos producidas por los equipos de energía, que representa múltiples riesgos potenciales para la salud del grupo quirúrgico, sin embargo, se han minimizado los peligros causados por la exposición de manera frecuente y acumulativa a este aerosol. Métodos. Se realizó un análisis crítico, desde una posición reflexiva de la información disponible, estableciendo los posibles riesgos relacionados con la exposición al humo quirúrgico. Discusión. Es visible la necesidad imperativa de establecer directrices nacionales, pautas normativas y recomendaciones estandarizadas para cumplir con las exigencias dadas por los sistemas de gestión en salud ocupacional y seguridad del trabajo, cuyo objetivo principal es hacer efectivo el uso de mascarillas quirúrgicas apropiadas, la implementación de programa de vigilancia epidemiológica ambiental en sala de cirugía, la priorización del uso constante de aspiradores y sistemas de evacuación, y la ejecución de programas educativos de sensibilización dirigidos al personal implicado. De igual manera, se abre la inquietud de la necesidad de nuevos estudios para definir con mayor precisión el peligro de este aerosol. Conclusión. Se recomienda de manera responsable utilizar todas las estrategias preventivas existentes para intervenir en salas de cirugía los riesgos minimizados y olvidados del humo quirúrgico.

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A systematic review of the harmful effects of surgical smoke inhalation on operating room personnel

Cited by 4 publications

References 43 publications

Use of mixed gas pneumoperitoneum during minimally invasive surgery: a systematic review of human and mouse modelled laparoscopic interventions

Use of mixed gas pneumoperitoneum during minimally invasive surgery: a systematic review of human and mouse modelled laparoscopic interventions

The Impact of Electrocautery Smoke on Surgical Staff and the Efficacy of Normal Surgical Masks Versus N95 Masks

El humo del electrocauterio, el riesgo olvidado y minimizado de la cirugía

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