Evaluation of fine particles in surgical smoke from an urologist’s operating room by time and by distance

Wang, Hong Kai; Mo, Fei; Guang, Chun; Dai, Bo; Shi, Guo Hai; Zhu, Yushan; Zhang, Hai Liang; Ye, Ding Wei

doi:10.1007/s11255-015-1080-3

Cited by 40 publications

(43 citation statements)

References 18 publications

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“…depending on the layout of the OR and the nature of the procedure. Another study using the Air Quality Index as the outcome measure recorded "very unhealthy" and "hazardous" air qualities during open urological surgeries [19].…”

Section: Discussionmentioning

confidence: 99%

“…It should be noted that our measurements of smoke were obtained at the anesthetist's side of the surgical drapes; the "actual" exposure of the scrubbed personnel could thus be much higher. In urological surgeries, for example, the average concentration of smoke particles in the air increased by 13 times when the smoke particle counter was moved closer to the surgical site from 48 to 16 inches [19]. Also, careful risk assessment should consider the exposure over time: low dose exposure on a regular basis is still concerning.…”

Section: Discussionmentioning

confidence: 99%

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The utility of local smoke evacuation in reducing surgical smoke exposure in spine surgery: a prospective self-controlled study

Liu

Filipp²,

Wood

2020

The Spine Journal

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BACKGROUND CONTEXT: Exposure to surgical smoke remains a potential occupational health concern to spine operating room personnel. Using a smoke evacuator (local exhaust ventilation) is currently regarded as a primary means of protection, yet few studies have evaluated its utility in actual surgeries. OBJECTIVE: To examine the utility of two common types of local smoke evacuators, a para incisional evacuator and a smoke evacuation pencil, in reducing surgical smoke exposure in spine surgery. STUDY DESIGN: A prospective self-controlled study. PATIENT SAMPLE: After the pre-estimation of sample size, 51 consecutive spine surgeries (25 and 26 patients using the para incisional smoke evacuator and the smoke evacuation pencil, respectively) were enrolled between February 2018 and March 2019. OUTCOME MEASURES: Two outcome measures were used to evaluate the level of surgical smoke exposure, which was defined as the concentration of ultrafine smoke particles in the air (number of particles per cm 3 , ppc) around the operating table: (a) the average smoke level was the arithmetic mean of all measurements recorded during the surgery; and (b) the peak smoke level was the highest measurement recorded. METHODS: Consecutive surgeries that involved bilateral symmetrical surgical exposure of the spine via a posterior midline incision were evaluated. Cauterized smoke was evacuated by two smoke evacuators: a "para incisional evacuator," which used a flat broad suction pad positioned immediately adjacent to the incision (25 patients), and a "surgical smoke evacuation pencil" which is an incorporated part of the electrocautery (26 patients). The level of smoke exposure was measured separately when surgically exposing the two sides of the spine: starting with one side (determined randomly) with the smoke evacuator being turned on and, then, the other side with the smoke evacuator off. The results were compared between the two sides. RESULTS: The para incisional smoke evacuator significantly reduced the average smoke level by an average of 59.7% (287 [interquartile range {IQR}: 126, 526] vs. 1,177 [IQR: 395, 2,702], p<.001). The surgical smoke evacuation pencil also reduced the average smoke level by an average of 44.1% (917 [IQR: 448, 1936] vs. 1,605 [IQR: 775, 4,280], p<.001). Both evacuators significantly reduced peak smoke levels as well. FDA device/drug status: Approved (miniSQUAIR,

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The utility of local smoke evacuation in reducing surgical smoke exposure in spine surgery: a prospective self-controlled study

Liu

Filipp²,

Wood

2020

The Spine Journal

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“…The surgical ports are the point of evacuation but only after the mist has spread from the tip of LCS and obstructed the surgical field. Mist can be aspirated more efficiently if the aspiration is performed close to the point of origin of the mist before it diffuses within the peritoneal cavity [20,21].…”

Section: Distance From Mist Originmentioning

confidence: 99%

Evaluation of the safety and efficacy of suction-tip forceps, a new tool for laparoscopic surgery, in patients with gastric cancer: Preliminary results from a prospective trial

Sakurazawa

Harada

Ando

et al. 2019

Preprint

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Background Laparoscopic surgery is widely accepted as minimally invasive surgery; however, obstacles to its functional optimization remain. One such challenge is that each surgical port can accommodate only one instrument at a time. Complex manipulations are therefore necessary to exchange one laparoscopic tool with another during surgery (e.g., removal of forceps and placement of a suction tube), which increases operation times and risk to patients. We developed a new laparoscopic instrument that functions as both forceps and a suction tube, which renders intraoperative tool exchange unnecessary. This prospective pilot study was undertaken to evaluate the safety and efficacy of this novel dual-function device in laparoscopic surgery for gastric cancer. Methods This single-center prospective pilot study was undertaken with 15 patients who required laparoscopic distal gastrectomy for gastric cancer. To assess patient safety, intraoperative video was used to document any tissue damage associated with the new instrument. To evaluate instrument efficacy, we measured the time interval between the start of bleeding and the start of aspiration (“suction access time”) and compared this time with that of a conventional surgical setup. Results All procedures were successful, and no excess tissue damage occurred during surgery with the suction-tip forceps. Bleeding occurred 158 times. Suction access time was significantly shorter in cases of bleeding when the suction-tip forceps were used (2.01 seconds) than when an ordinary suction tube was used for aspiration (12.5 seconds; P < 0.01). Conclusion These findings suggest that our new suction-tip forceps are a useful, safe, and efficacious operative tool. This surgical innovation may considerably simplify gastric laparoscopic surgery. This pilot study was registered with Japan Clinical Trial Registration on June 22, 2017 (registration number: UMIN000027879).

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“…Surgical smoke contains toxic chemicals such as hydrogen cyanide, 9 inorganic gases (eg, carbon monoxide), 9 aromatic hydrocarbons (eg, benzene, toluene), 9 volatile organic compounds, particles, 10 viruses (eg, human papillomavirus), 11 blood fragments, 12 and cancer cells 13 . The potential health effects related to the inhalation of surgical smoke are numerous 14 .…”

Section: Implementing Surgical Smoke Evacuation Practicesmentioning

confidence: 99%

Clinical Issues‐February 2017

Ogg¹,

Wood²

2017

AORN Journal

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Implementing surgical smoke evacuation practices Key words: surgical smoke, compliance, health effects, smoke evacuators. Surgical smoke evacuation policies and procedures Key words: surgical smoke, smoke evacuation, policy, procedure. Measuring compliance with surgical smoke evacuation practices Key words: surgical smoke, smoke evacuation, compliance. Patient safety and hand hygiene Key words: hand hygiene, hand wash, hand rub, patient safety, point of use.

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Evaluation of fine particles in surgical smoke from an urologist’s operating room by time and by distance

Cited by 40 publications

References 18 publications

The utility of local smoke evacuation in reducing surgical smoke exposure in spine surgery: a prospective self-controlled study

The utility of local smoke evacuation in reducing surgical smoke exposure in spine surgery: a prospective self-controlled study

Evaluation of the safety and efficacy of suction-tip forceps, a new tool for laparoscopic surgery, in patients with gastric cancer: Preliminary results from a prospective trial

Clinical Issues‐February 2017

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