Health risk to medical personnel of surgical smoke produced during laparoscopic surgery

Abstract

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.

Complications, Implications, and Prevention of Electrosurgical Injuries: Corner Stone of Diathermy Use for Junior Surgical Trainees

“…Although there are no documented cases of cancers directly related to exposure of smoke produced from diathermy, there have been several cases of minor respiratory illness and ocular irritation. 13,14 These particles could easily be inhaled in spite of wearing masks. The average pore size of a surgical mask is 5 µm, whereas most of the particles contained in the smoke measure between 1.0 and 1.5 µm.…”

Chemical composition of surgical smoke produced during Loop electrosurgical excision procedure treating cervical intraepithelial neoplasia

“…Aldehydes, benzene, toluene, ethylbenzene, xylene, ozone, dioxins and furans were indentified. But all of them were lower than the hygienic standards allowed by the European Union Maximum Acceptable Concentration[28]. This is the first time to evaluate chemical composition of smoke produced during LEEP.…”

Laparoscopic Surgery in COVID-19 Era—Safety and Ethical Issues

“…Previous studies show that chronic exposure can cause respiratory problems (cough, laryngitis, chronic bronchitis), eye irritation, headaches and even carcinogenic potential. The main substances identified were-aromatic hydrocarbons (benzene, toluene, ethylbenzene), aldehydes (formaldehyde, benzyl aldehyde, furfural, acrylaldehyde), nitriles, with a possible generation of hydrocyanic acid, furans [14][15][16][17]. Studies have been performed in laboratories showing various pulmonary changes in rats when exposed to smoke plumes [18].…”