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

Abstract

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.

Expert consensus from the Italian Society for Colposcopy and Cervico‐Vaginal Pathology (SICPCV) for colposcopy and outpatient surgery of the lower genital tract during the COVID‐19 pandemic

“…Surgical smoke may contain viral particles, as reported in studies of cervical excision procedures performed by LEEP or CO2 laser, whereby HPV was found in the upper airway mucosa of the surgeons . Other viruses, such as HIV or hepatitis B, have also been detected in surgical smoke . Even if this kind of transmission is more likely for blood‐borne viruses and that at present there are no recorded cases of vaginal secretions testing positive for COVID‐19, we cannot underestimate the risk of COVID‐19 infection by aerosol from surgical smoke.…”

Applications of Near Infrared Photoacoustic Spectroscopy for Analysis of Human Respiration: A Review

“…Surgical smoke consists of 95% water and 5% cellular debris in the form of particles such as chemicals, blood and tissue particles, viruses, and bacteria [182]. Surgical smoke has been shown to exhibit potential risks for surgeons, nurses, anesthesiologists, and technicians in the operation room due to long term exposure of smoke [183]. The chemicals are gases and vapors and consist contains more than 80 different toxic chemicals and byproducts such as: acrolein (a known carcinogen), acetonitrile, acrylonitrile (long term exposure causes cancer), benzene (a known carcinogen), butadiene (a known carcinogen), carbon monoxide, ethylene, formaldehyde (a known carcinogen, used to preserve surgical specimens and as an embalming fluid), free radicals, hydrogen cyanide (neurotoxin used in chemical warfare, is cardio-toxic), ammonia, toluene (a known carcinogen), etc.…”

Surgical Smoke—Hazard Perceptions and Protective Measures in German Operating Rooms

“…It was already shown, in the 1970s, that laser treatments release surgical smoke which also contains active biological components such as cells or cell parts [9]. Infectious agents contained in surgical smoke such as staphylococci or human papillomavirus can cause infections in exposed individuals [2,10,11].…”

“…Surgical smoke is associated with dose-dependent health complaints such as headache, weakness, nausea, rhinitis, or a burning sensation in the nasopharynx [4,12], but also with more serious conditions such as asthma or pneumonia [13]. A causal relationship between neurotoxic, carcinogenic, and mutagenic substances in surgical smoke [6,11,12,14,15] and tumors appears to be possible and is discussed in case studies [16,17]. Meaningful empirical evidence of causal relationships is not provided by the current study situation, despite the toxic substances contained therein [18][19][20][21].…”