scholarly journals Laparoscopic surgery during the COVID-19 pandemic: detection of SARS-COV-2 in abdominal tissues, fluids, and surgical smoke

2021 ◽  
Author(s):  
Isaac Cheruiyot ◽  
Prabjot Sehmi ◽  
Brian Ngure ◽  
Musa Misiani ◽  
Paul Karau ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Smoke

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

2015 ◽  
Vol 28 (5) ◽  
pp. 831-840 ◽  
Author(s):  
Miłosz Dobrogowski ◽  
Wiktor Wesolowski ◽  
Małgorzata Kucharska ◽  
Katarzyna Paduszyńska ◽  
Agnieszka Dworzyńska ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Health Risk ◽  
Medical Personnel ◽  
Surgical Smoke

scholarly journals Comparison of surgical smoke between open surgery and laparoscopic surgery for colorectal disease in the COVID-19 era

2021 ◽  
Author(s):  
Hitoshi Kameyama ◽  
Tetsuya Otani ◽  
Toshiyuki Yamazaki ◽  
Akira Iwaya ◽  
Hiroaki Uehara ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Open Surgery ◽  
Colorectal Disease ◽  
Surgical Smoke

scholarly journals Laparoscopic surgery produced less surgical smoke and contamination comparing with open surgery: the pilot study in fresh cadaveric experiment in COVID-19 pandemic

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Voraboot Taweerutchana ◽  
Tharathorn Suwatthanarak ◽  
Asada Methasate ◽  
Thawatchai Akaraviputh ◽  
Jirawat Swangsri ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Laparoscopic Appendectomy ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Abdominal Cavity ◽  
Particle Sizes ◽  
Open Approach ◽  
Surgical Smoke ◽  
Surgical Field

Abstract Background The SARS-CoV2 virus has been identified in abdominal cavity of the COVID-19 patients. Therefore, the potential viral transmission from any surgical created smoke in these patients is of concern especially in laparoscopic surgery. This study aimed to compare the amount of surgical smoke and surgical field contamination between laparoscopic and open surgery in fresh cadavers. Methods Cholecystectomy in 12 cadavers was performed and they were divided into 4 groups: laparoscopic approach with or without smoke evacuator, and open approach with or without smoke evacuator. The increased particle counts in surgical smoke of each group were analyzed. In the model of appendectomy, surgical field contamination under ultraviolet light and visual contamination scale between laparoscopic and open approach were compared. Results Open cholecystectomy significantly produced a greater amount of overall particle sizes, particle sizes < 5 μm and particle sizes ≥ 5 μm than laparoscopic cholecystectomy (10,307 × 103 vs 3738 × 103, 10,226 × 103 vs 3685 × 103 and 81 × 103 vs 53 × 103 count/m3, respectively at p < 0.05). The use of smoke evacuator led to decrease in the amount of overall particle sizes of 58% and 32.4% in the open and laparoscopic chelecystectomy respectively. Median (interquatile range) visual contamination scale of surgical field in open appendectomy [3.50 (2.33, 4.67)] was significantly greater than laparoscopic appendectomy [1.50 (0.67, 2.33)] at p < 0.001. Conclusions Laparoscopic cholecystectomy yielded less smoke-related particles than open cholecystectomy. The use of smoke evacuator, abeit non-significantly, reduced the particles in both open and laparoscopic cholecystectomy. Laparoscopic appendectomy had a lower degree of surgical field contamination than the open approach.

scholarly journals Aerosols, airflow, and airspace contamination during laparoscopy

2021 ◽  
Author(s):  
N Hardy ◽  
J Dalli ◽  
M F Khan ◽  
K Nolan ◽  
R A Cahill
Keyword(s):  
Laparoscopic Surgery ◽  
Real Time ◽  
Operating Room ◽  
Best Practice ◽  
Occupational Hazard ◽  
Surgical Smoke ◽  
Operating Team ◽  
Infectious Risk ◽  
Surgical Teams

Lay summary Laparoscopic surgery has been undermined throughout the COVID-19 pandemic by concerns that it may generate an infectious risk to the operating team through aerosolization of peritoneal particles. There is anyway a need for increased awareness and understanding of the occupational hazard for surgical teams regarding unfiltered escape of pollutants generated by surgical smoke and other microbials. Here, the aerosol-generating nature of this access modality was confirmed through repeatable real-time methodology both qualitatively and quantitively to inform best practice and additional engineering solutions to optimize the operating room environment.

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

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 673
Author(s):  
Dragos Serban ◽  
Catalin Gabriel Smarandache ◽  
Corneliu Tudor ◽  
Lucian Nicolae Duta ◽  
Ana Maria Dascalu ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Ethical Issues ◽  
Biologically Active ◽  
Published Data ◽  
Protective Equipment ◽  
Active Materials ◽  
Protective Measures ◽  
Surgical Smoke ◽  
Toxic Risk ◽  
Smoke Evacuation

(1) Background: The paper aims to review the available evidence regarding the health risk of the aerosolization induced by laparoscopy induced and impact of the COVID-19 pandemic upon minimally invasive surgery. (2) Materials and methods: A systematic review of the literature was performed on PubMed, Medline and Scopus until 10 July. (3) Results: Chemicals, carcinogens and biologically active materials, such as bacteria and viruses, have been isolated in surgical smoke. However, the only evidence of viral transmission through surgical smoke to medical staff is post-laser ablation of HPV-positive genital warts. The reports of SARS-CoV-2 infected patients who underwent laparoscopic surgery revealed the presence of the virus, when tested, in digestive wall and stools in 50% of cases but not in bile or peritoneal fluid. All surgeries did not result in contamination of the personnel, when protective measures were applied, including personal protective equipment (PPE) and filtration of the pneumoperitoneum. There are no comparative studies between classical and laparoscopic surgery. (4) Conclusions: Previously published data showed there is a possible infectious and toxic risk related to surgical smoke but not particularly proven for SARS-CoV-2. Implementing standardized filtration systems for smoke evacuation during laparoscopy, although increases costs, is necessary to increase the safety and it will probably remain a routine also in the future.

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