Surgical smoke management for minimally invasive (micro)endoscopy: an experimental study

Mattes, Dietmar; Silajdzic, Edah; Mayer, M.; Horn, Martin; Scheidbach, Daniel; Wackernagel, Werner; Langmann, G.; Wedrich, Andreas

doi:10.1007/s00464-010-0991-4

Cited by 16 publications

(8 citation statements)

References 25 publications

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“…Thirdly, the tubing occasionally interfered with the surgeon's handling of the LCS dissector. Several studies have proposed a technical solution to efficiently remove surgical smoke via a conventional port [12,13]. However, our suggested system could decrease the risk of exposure to harmful chemicals and provide a clear view by the continuous evacuation of mist at the site of origin.…”

Section: A B D Cmentioning

confidence: 99%

How to Evacuate Surgical Smoke While Using Laparoscopic Coagulation Shears

Mitsuaki¹,

Horie²,

Koinuma³

et al. 2017

Adv Laparoscopy

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Introduction: During laparoscopic surgery, the production of smoke by energized dissecting devices is a problem because it can obstruct the view of the operative field. The products of combustion may also contain hazardous chemicals, such as benzene, toluene, viable cancer cells or viruses. However, these devices, in particular Laparoscopic Coagulation Shears (LCS), are often essential during laparoscopic surgery. We suggest a simple evacuation system to resolve this problem using intravenous tubing. Material and surgical technique:The intravenous tubing is cut diagonally, proximal to the drip chamber and sterile spike. The cut end of the tubing is taped to the shaft near the active blade side on the LCS. The luer-lock side of the tubing is connected to a suction source. The smoke and vapor arising at the dissection point during the use of the LCS are removed by the application of continuous suction to the tubing. Discussion:We describe a method for the efficient evacuation of combustion products generated by the intraoperative use of the LCS using an inexpensive and easily available device.

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Section: A B D Cmentioning

confidence: 99%

How to Evacuate Surgical Smoke While Using Laparoscopic Coagulation Shears

Mitsuaki¹,

Horie²,

Koinuma³

et al. 2017

Adv Laparoscopy

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“…Previous studies attempting to quantify hazardous gaseous products of energized dissection have largely used simulated surgical techniques in laboratories or on animal models, both live and slaughtered [5,6]. In these studies, electrocautery and ultrasonic energy settings were often unusually high or at maximal settings.…”

Section: Introductionmentioning

confidence: 99%

A single-blind controlled study of electrocautery and ultrasonic scalpel smoke plumes in laparoscopic surgery

2011

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Both electrocautery and ultrasonic dissection are associated with significantly lower concentrations of the most commonly detected carcinogenic and irritant hydrocarbons than cigarette smoke. A nonsignificant trend toward lower hydrocarbon concentrations was seen with ultrasonic scalpel dissection compared with diathermy. The contamination levels in city air were largely comparable with those seen after ultrasonic scalpel use. Although hydrocarbon concentrations are low, cumulative exposures may increase health risks. Where concerns arise, ultrasonic scalpel dissection may be preferable.

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“…Surgical smoke is another problem caused by heated electrodes [8,9]. Surgical smoke is generated when tissue is heated and cellular fluid is vaporized by the delivering energy of the electrosurgery, which may reduce the visibility of internal operating field [10]. The smoke has also been shown to contain noxious chemicals which are hazard to patients [11,12].…”

Section: Introductionmentioning

confidence: 99%

The Application of Advanced Nanostructured Film in Electrosurgical Device: Anti-Sticking Behavior and Thermal Injury

Cheng¹

2015

J Nanomed Nanotechnol

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Background: Minimally invasive surgery is performed using an endoscope and other instruments including the electrosurgical units. However, concerns including surgical smoke, tissue sticking, and thermal injury are remaining in electro surgery. Aims: Accordingly, a newly developed electrosurgical electrode coating with hydrogenated Cu-incorporated diamond-like carbon (DLC-Cu) film is purposed to improve the instrument performance. Methods: The morphologies of DLC-Cu surfaces were characterized using transmission electron microscopy, scanning electron microscopy and atomic force microscopy. In this study, lesions were made on the liver lobes of adult rats, using a monopolar electrosurgical unit equipped with untreated stainless steel electrodes or treated-electrodes. Animals were sacrificed for evaluations at 0, 3, 7, and 28 days post-operatively. Results: Treated-electrodes generate less sticking tissues and adhesive blood cells. Thermography revealed the surgical temperature in liver tissue from the treated-electrode was significantly lower than the untreated-electrode. Total injury area of livers treated with treated-electrodes was significantly smaller than the untreated-electrodes treatment. Moreover, treated-electrodes caused a relatively smaller area of lateral thermal injury, a smaller area of fibrotic tissue, and a faster process of remodeling than the untreated-electrodes. Western blot analysis showed that rats treated with treated-electrode expressed lower levels of NF-κB, caspase-3, and MMP-9 than untreated-electrode. Immunofluorescence staining for caspase-3 revealed the untreated-electrode caused more serious injury. Conclusions: This study reveals that the plating of electrodes with hydrogenated Cu-incorporated diamond-like carbon film is an efficient method for improving the performance of electrosurgical units. However, more tests must be carried out to confirm these promising findings in human patients.

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Surgical smoke management for minimally invasive (micro)endoscopy: an experimental study

Cited by 16 publications

References 25 publications

How to Evacuate Surgical Smoke While Using Laparoscopic Coagulation Shears

How to Evacuate Surgical Smoke While Using Laparoscopic Coagulation Shears

A single-blind controlled study of electrocautery and ultrasonic scalpel smoke plumes in laparoscopic surgery

The Application of Advanced Nanostructured Film in Electrosurgical Device: Anti-Sticking Behavior and Thermal Injury

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