Surgical smoke – what are the risks?

Addley, Susan; Quinn, Declan

doi:10.1111/tog.12552

Cited by 8 publications

(15 citation statements)

References 41 publications

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“…This failure can be partly explained by variations in the knowledge of the risks posed by surgical smoke, and the available technology across all perioperative staff groups. 11,27,31 However, this is something that can be improved through interdisciplinary education 32 and healthcare organisations investing in the available technology and responsible individuals using it when indicated. Despite uncertainty about the degree of harm that exposure can cause, there is enough evidence to support limiting exposure.…”

Section: Nonmaleficencementioning

confidence: 99%

The case for compulsory surgical smoke evacuation systems in the operating theatre

Cooper

2021

Clinical Ethics

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Perioperative staff are frequently exposed to surgical smoke or plume created by using heat-generating devices like diathermy and lasers. This is a concern due to mounting evidence that this exposure can be harmful with no safe level of exposure yet identified. First, I briefly summarise the problem posed by surgical smoke exposure and highlight that many healthcare organisations are not sufficiently satisfying their legal and ethical responsibilities to protect their staff from potential harm. Second, I explore the ethical case for compulsory smoke evacuation systems using the principlist framework and its four ethical principles – autonomy, beneficence, nonmaleficence, and justice. I then consider some objections and argue that surgical smoke evacuation systems – when indicated – should be made compulsory.

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Section: Nonmaleficencementioning

confidence: 99%

The case for compulsory surgical smoke evacuation systems in the operating theatre

Cooper

2021

Clinical Ethics

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“…In contrast to ABDs, cutting and haemostasis is achieved in one step, resulting in improved ergonomics. UDs tend to generate less smoke plume than ABDs, 9 conveying the benefit of improved visibility and reduced risks of exposure for the surgical team 11 . Sonicision is cordless, with a reusable handheld generator and rechargeable battery.…”

Section: Types Of Advanced Energy Devicesmentioning

confidence: 99%

“…High‐power LDs pose a considerable fire hazard through their potential to ignite flammable materials in the operating room. In addition, LDs, especially CO 2 lasers, generate large amounts of surgical plume, posing a further health risk to theatre staff 11 . Departments utilising LDs must adhere to strict safety protocols, including appointing a laser safety officer to supervise all aspects of risk management 26 …”

Section: Types Of Advanced Energy Devicesmentioning

confidence: 99%

Review of advanced energy devices for the minimal access gynaecologist

Bentham

Preshaw

2021

The Obstetric & Gynaecologis

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Key content Contemporary energy devices utilise advanced bipolar, ultrasound, hybrid technology, plasma beam and laser energy. Each energy modality has specific characteristics influencing its particular benefits and disadvantages. Gynaecologists must be aware of the available energy modalities to select the optimum device. Minimal access surgeons must demonstrate a comprehensive understanding of their instruments to ensure surgical success and safety. Learning objectives To understand the biophysics of advanced energy devices and their practical applications. To review advantages, disadvantages and safety issues associated with each modality and offer practical tips and problem‐solving for commonly available devices. To enable surgeons to select the optimal device for their surgical tasks. Ethical issues Trainee minimal access surgeons should have solid theoretical knowledge of energy devices before performing hands‐on surgery. Consideration of the safety aspects of energy devices will enable surgeons to minimise harm to their patients. Potentially high investment costs necessitate consideration of the anticipated benefits of energy devices to ensure value for money.

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“…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].…”

Section: Origin and Properties Of Surgical Smokementioning

confidence: 99%

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

Michaelis

Hofmann

Nienhaus

et al. 2020

IJERPH

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(1) Background: Hazardous substances in surgical smoke that is generated during laser or electrosurgery pose a potential health hazard. In Germany, the Technical Rules for Hazardous Substances (TRGS 525) have included recommendations for appropriate protective measures since 2014. Up to now, no empirical data has been available on the extent to which recommendations have been implemented in practice. (2) Methods: In 2018, 7089 surgeons in hospitals and outpatient practices were invited by email to participate in an online survey. In addition, 219 technical assistants were interviewed. The questionnaire dealt with knowledge of, and attitudes toward, the hazard potential of surgical smoke, as well as the availability and actual use of protective measures. Furthermore, manufacturers and distributors of smoke extraction devices were asked to give their assessment of the development of prevention in recent years. (3) Results: The survey response rate was 5% (surgeons) and 65% (technical assistant staff). Half of all surgeons assumed that there were high health hazards of surgical smoke without taking protective measures. Operating room nurses were more often concerned (88%). Only a few felt properly informed about the topic. The TRGS recommendations had been read by a minority of the respondents. In total, 52% of hospital respondents and 65% of the respondents in outpatient facilities reported any type of special suction system to capture surgical smoke. One-fifth of respondents from hospitals reported that technical measures had improved since the introduction of the TRGS 525. Fifty-one percent of the surgeons in hospitals and 70% of the surgeons in outpatient facilities “mostly” or “always” paid attention to avoiding surgical smoke. The most important reason for non-compliance with recommendations was a lack of problem awareness or thoughtlessness. Twelve industrial interviewees who assessed the situation and the development of prevention in practice largely confirmed the prevention gaps observed; only slight developments were observed in recent years. (4) Conclusions: The low response rate among surgeons and the survey results both indicate a major lack of interest and knowledge. Among other measures, team interventions with advanced training are needed in the future.

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Surgical smoke – what are the risks?

Cited by 8 publications

References 41 publications

The case for compulsory surgical smoke evacuation systems in the operating theatre

The case for compulsory surgical smoke evacuation systems in the operating theatre

Review of advanced energy devices for the minimal access gynaecologist

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

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