Advocating for surgical smoke evacuation legislation

AORN Journal ◽  
2021 ◽  
Vol 114 (4) ◽  
Keyword(s):  
Surgical Smoke ◽  
Smoke Evacuation

scholarly journals Smoke Evacuation During Laparoscopic Surgery: A Problem Beyond the COVID-19 Period. A Quantitative Analysis of CO2 Environmental Dispersion Using Different Devices

2021 ◽  
pp. 155335062110148
Author(s):  
Umberto Bracale ◽  
Vania Silvestri ◽  
Emanuele Pontecorvi ◽  
Immacolata Russo ◽  
Maria Triassi ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Quantitative Analysis ◽  
Flow Rate ◽  
Healthcare Professionals ◽  
Operative Time ◽  
Mean Value ◽  
Operating Theater ◽  
Surgical Smoke ◽  
Smoke Evacuation ◽  
Group A

Background. The COVID-19 pandemic leads to several debates regarding the possible risk for healthcare professionals during surgery. SAGES and EAES raised the issue of the transmission of infection through the surgical smoke during laparoscopy. They recommended the use of smoke evacuation devices (SEDs) with CO2 filtering systems. The aim of the present study is to compare the efficacy of different SEDs evaluating the CO2 environmental dispersion in the operating theater. Methods. We prospectively evaluated the data of 4 group of patients on which we used different SEDs or standard trocars: AIRSEAL system (S1 group), a homemade device (S2 group), an AIRSEAL system + homemade device (S3 group), and with standard trocars and without SED (S4 group). Quantitative analysis of CO2 environmental dispersion was carried out associated to the following data in order to evaluate the pneumoperitoneum variations: a preset insufflation pressure, real intraoperative pneumoperitoneum pressure, operative time, total volume of insufflated CO2, and flow rate index. Results. 16 patients were prospectively enrolled. The [CO2] mean value was 711 ppm, 641 ppm, 593 ppm, and 761 ppm in S1, S2, S3, and S4 groups, respectively. The comparison between data of all groups showed statistically significant differences in the measured ambient CO2 concentration. Conclusion. All tested SEDs seem to be useful to reduce the CO2 environmental dispersion respect to the use of standard trocars. The association of AIRSEAL system and a homemade device seems to be the best solution combining an adequate smoke evacuation and a stable pneumoperitoneum during laparoscopic surgery.

scholarly journals Prospective Randomized Study Evaluating the Usefulness of a Surgical Smoke Evacuation System in Operating Rooms for Breast Surgery

2020 ◽  
Author(s):  
Yutaka Tokuda ◽  
Takuho Okamura ◽  
Miki Maruta ◽  
Mutsuko Orita ◽  
Miyuki Noguchi ◽  
...  
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Randomized Study ◽  
Personal Exposure ◽  
Prospective Randomized Study ◽  
Surgical Smoke ◽  
Volatile Organic ◽  
Smoke Evacuation ◽  
Exposure Levels ◽  
Evacuation System

Abstract Background No prospective evaluation of surgical smoke evacuation systems has yet been conducted anywhere in the world. A prospective randomized study was conducted to clarify the usefulness of a surgical smoke evacuation system in terms of reducing the quantity of environmental pollutants found in operating room air and reducing the occupational exposure of doctors and nurses involved in surgical procedures to surgical smoke, volatile organic compounds, formaldehyde, etc. Methods Operating room environment conditions with and without the use of a surgical smoke evacuation system were measured, and the personal exposure levels of doctors and nurses involved in surgical procedures were also surveyed. Use of the evacuation system was determined randomly, and the procedures involved were breast-conserving surgery and mastectomy, which were treated as stratification factors. Results The average total volatile organic compound concentration in the operating room was significantly lower when the evacuation system was used compared with when it was not used. The findings were similar for formaldehyde concentration. Multiple regression analysis for healthcare professionals’ personal exposure levels showed that the evacuation system was a factor that significantly impacted their formaldehyde and acetaldehyde personal exposure levels, which were greatly reduced by the use of the system. Conclusion This study’s findings demonstrate the effectiveness of the evacuation systems, which should increase awareness that their benefits take priority over the drawbacks.

scholarly journals The Dangers of Electrosurgical Smoke to Operating Room Personnel: A Review

2017 ◽  
Vol 65 (11) ◽  
pp. 517-526 ◽  
Author(s):  
Kevin Bree ◽  
Spencer Barnhill ◽  
William Rundell
Keyword(s):  
Operating Room ◽  
Health Care Providers ◽  
Responsibility To Protect ◽  
Care Providers ◽  
Operating Room Personnel ◽  
Surgical Smoke ◽  
The United Kingdom ◽  
Smoke Evacuation ◽  
Harmful Effects

A 2007 study in the United Kingdom showed that three of 98 surgeons surveyed admitted using dedicated smoke extractors; 72% of respondents believed inadequate precautions were in place to protect staff from the potential dangers of electrosurgical smoke. Surgical smoke contains harmful chemicals (e.g., hydrogen cyanide, acetylene, and butadiene) that can circumvent standard masks used in the operating room (OR). In addition, bacteria and viruses can be transmitted through this smoke. The topic of electrosurgical smoke is important to occupational health nurses not only because of their responsibility to protect workers, but also because they, like other health care providers, may be exposed to smoke routinely. The authors of this review recommend the regular use of smoke evacuation in ORs and avoidance of electrosurgery whenever possible to protect OR personnel from the potential long-term harmful effects of electrosurgical smoke.

Operation Clean Air: Implementing a Surgical Smoke Evacuation Program

AORN Journal ◽  
2017 ◽  
Vol 106 (6) ◽  
pp. 502-512 ◽  
Author(s):  
Mary K. Dobbie ◽  
Maria Fezza ◽  
Martha Kent ◽  
Jane Lu ◽  
Mark L. Saraceni ◽  
...  
Keyword(s):  
Surgical Smoke ◽  
Smoke Evacuation ◽  
Clean Air

scholarly journals Prospective Randomized Study Evaluating the Usefulness of a Surgical Smoke Evacuation System in Operating Rooms for Breast Surgery

2020 ◽  
Author(s):  
Yutaka Tokuda ◽  
Takuho Okamura ◽  
Miki Maruta ◽  
Mutsuko Orita ◽  
Miyuki Noguchi ◽  
...  
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Randomized Study ◽  
Personal Exposure ◽  
Prospective Randomized Study ◽  
Surgical Smoke ◽  
Volatile Organic ◽  
Smoke Evacuation ◽  
Exposure Levels ◽  
Evacuation System

Abstract Background: No prospective evaluation of surgical smoke evacuation systems has yet been conducted anywhere in the world. A prospective randomized study was conducted to clarify the usefulness of a surgical smoke evacuation system in terms of reducing the quantity of environmental pollutants found in operating room air and reducing the occupational exposure of doctors and nurses involved in surgical procedures to surgical smoke, volatile organic compounds, formaldehyde, etc. Methods: Operating room environment conditions with and without the use of a surgical smoke evacuation system were measured, and the personal exposure levels of doctors and nurses involved in surgical procedures were also surveyed. Use of the evacuation system was determined randomly, and the procedures involved were breast-conserving surgery and mastectomy, which were treated as stratification factors. Results: The average total volatile organic compound concentration in the operating room was significantly lower when the evacuation system was used compared with when it was not used. The findings were similar for formaldehyde concentration. Multiple regression analysis for healthcare professionals’ personal exposure levels showed that the evacuation system was a factor that significantly impacted their formaldehyde and acetaldehyde personal exposure levels, which were greatly reduced by the use of the system. Conclusion: This study’s findings demonstrate the effectiveness of the evacuation systems, which should increase awareness that their benefits take priority over the drawbacks. Trial Registration: The study was conducted after explaining to participants that it was a study of operating room environments in which their participation was voluntary and obtaining their consent. The study was also approved by the Tokai University Hospital clinical research review committee (no. 5R-022) and registered with the UMIN registry　(UMIN000029092) on 13, September, 2017-　retrospectively registered, http://www.umin.ac.jp/ctr/UMIN000029092.

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