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

2021 ◽  
pp. 147775092110635
Author(s):  
Daniel Rodger
Keyword(s):  
Smoke Exposure ◽  
Operating Theatre ◽  
Ethical Principles ◽  
Surgical Smoke ◽  
Potential Harm ◽  
Safe Level ◽  
Smoke Evacuation ◽  
Ethical Responsibilities

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.

scholarly journals Use of urinary hippuric acid and o-/p-/m-methyl hippuric acid to evaluate surgical smoke exposure in operating room healthcare personnel

2021 ◽  
Vol 217 ◽  
pp. 112231
Author(s):  
Chun-Hui Chiu ◽  
Chi-Tsung Chen ◽  
Ming-Huei Cheng ◽  
Li-Heng Pao ◽  
Chi Wang ◽  
...  
Keyword(s):  
Operating Room ◽  
Hippuric Acid ◽  
Smoke Exposure ◽  
Healthcare Personnel ◽  
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 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.

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