<p>Human papillomavirus DNA in surgical smoke during cervical loop electrosurgical excision procedures and its impact on the surgeon</p>

Abstract

Objective: The purpose of this study was to explore whether human papillomavirus (HPV) DNA is present in surgical smoke generated by loop electrosurgical excision procedures (LEEPs). Furthermore, we investigated the impact of this HPV DNA on surgeons. Methods: A total of 134 outpatients with persistent HPV infections treated with LEEP for cervical intraepithelial neoplasia between 2015 and 2016, along with the corresponding LEEP operators, were included. The flow fluorescence in situ hybridization technique was used to detect HPV DNA in exfoliated cervical cells from the patients, in surgical smoke and in nasal epithelial cells from the surgeons before and after LEEP. Results: The positive rates of HPV DNA in the three types of samples mentioned above were 94.8%, 29.9% and 1.5%, respectively. The distribution of HPV subtypes in surgical smoke was identical to that in the cervical specimens. The positive rate of HPV DNA in surgical smoke was significantly increased for greater distances of the suction device from the surgical site. The nasal epithelial cells of two surgeons were positive for HPV DNA, and the genotypes were consistent with those in the corresponding surgical smoke. After a 3–6-month follow-up, the nasal swabs from these two doctors tested negative for HPV DNA. Conclusions: This study demonstrated the presence of HPV DNA in surgical smoke produced by LEEP and the risk of airborne transmission of HPV DNA during the operation. Fortunately, the HPV DNA in the nasopharynx of the operators was not persistent.

Closed circuit system in laparoscopy: SARS-CoV-2 pandemic

“…The presence of Hepatitis B virus (HBV)/HCV/HIV/HPV Deoxyribonucleic acid (DNA) in surgical smoke has been well proven in multiple studies. [1][2][3] HPV transmission during anogenital surgery is most widely reported in the literature. Liu et al outlined four articles linking surgical smoke to the transmission of HPV (type 6,11,13), progressing to oropharyngeal squamous cell carcinoma.…”

“…Many studies have shown the presence of human immunodeficiency virus (HIV), human papillomavirus (HPV), hepatitis B surface antigen (HbSAg) and hepatitis C virus (HCV) in the cautery smoke. [1][2][3] Research has shown the presence of SARS COV-2 in feces, blood, peritoneal fluid and mucosa. 4 SARS-CoV-2 Ribonucleic acid (RNA) has been found in the feces of infected patients.…”

A systematic review of viral transmission risk to healthcare staff comparing laparoscopic and open surgery

“…When healthcare staff risk was investigated, Weyandt and Zhou have shown that samples taken from the operating surgeons were positive for viral DNA from HPV. 18,21 However, there were differences shown within these studies as Weyandt found that viral DNA obtained from operators was not consistent with that of the patients they were operating on. 18 In contrast to this, Zhou demonstrated consistency between operator and patient viral DNA subtypes.…”

Recommendations for Gynecological Endoscopic Surgery during COVID-19 Pandemic

“…This raises the concerns of spread of infection from inhalation of surgical smoke during the use of electrosurgery and CO 2 used for the creation and maintenance of pneumoperitoneum. [12][13][14] Surgical smoke has been demonstrated to have viral deoxyribonucleic acid, but the inhalation of smoke resulting in disease has not been adequately evaluated. There are reports of identifying human papilloma virus, human immunodeficiency virus, and hepatitis B virus in surgical smoke, but their infectivity is unknown and hence universal precautions are recommended during surgery.…”