Surgical smoke is made of 95% water and 5% cellular debris. The cellular debris includes but is not limited to chemicals, blood and tissue particles, viruses, and bacteria. Surgical smoke is created during both open and laparoscopic procedures. [1] It is generated by the interaction of tissue with heat-producing equipment that is often used for dissection and hemostasis. The size of the particles in the smoke varies; however, the smaller the particles are, the further they can travel, causing harm to the doctors in the sterile field and other members in the OR. Surgical smoke has been shown to cause various respiratory diseases as the particles adhere to the walls of the lungs when inhaled. [2] The patient is also affected by the surgical smoke. The longer the smoke sits inside the patient’s cavity, the more it is absorbed into the patient’s membranes and subsequently their bloodstream. This can lead to elevated readings and could leave certain conditions such as hypoxia to go unrecognized and untreated. [2]
Surgical smoke often has an unpleasant odor, has been shown to have mutagenic potential, and can visually impair the doctor’s field of view. Although doctors are wearing surgical masks when operating, the effectiveness of these masks at filtrating the air they breathe is not always enough to stop these particles. The efficacy of surgical masks dramatically decreases when the mask is worn too loosely or for too long. Most surgical masks can only filter particles five micrometers or larger. Laser surgical masks have higher filtration capabilities and can filter particles as small as 0.1 micrometers. Most of the particles in surgical smoke are 1.1 micrometers or smaller, and viruses can be as small as 0.01 micrometers. [2] This means surgical masks are highly ineffective at protecting doctors from the dangers of surgical smoke unless they are equipped with a laser surgical mask. The smoke also obstructs the doctor’s ability to see, so they must wait for the smoke to clear before operating again. This can lead to mistakes, longer surgery times, and a higher risk for complications.
NIOSH recommends that general room and local exhaust ventilation be used since general room ventilation itself cannot capture contaminants close to the source. Room suction systems are a type of local exhaust ventilation better suited for capturing liquid rather than gases. They can be adapted to capture smoke by installing a filter. Smoke evacuators are more efficient at clearing surgical smoke. Smoke evacuators have a suction component that is hooked up to a vacuum. There are filters within the device which trap the hazardous particles at the source before they are dispersed into the air. These devices clear smoke from the source, making it easier for the doctors to operate and reducing the amount of smoke inhaled. [3]
There is legislation being proposed in numerous states to help protect patients and doctors from the dangers of surgical smoke. However, currently, only nine states have gone surgical smoke-free.[4] To learn more about what it means to go surgical smoke-free and to see if your state is surgical smoke-free, check out this post Which states currently have surgical smoke-free regulations, and which are coming up? (boehringerlabs.com).
The VISIMAX® is a laparoscopic smoke evacuation system that removes surgical smoke created during minimally invasive surgery. It is a disposal device that does not interfere with insufflators and effectively clears surgical smoke from the operating space.
[1} Romano F, Gustén J, De Antonellis S, Joppolo CM. Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres. Int J Environ Res Public Health. 2017;14(2):137. doi:10.3390/ijerph14020137
[2] Ulmer, B. C. (2008). The hazards of surgical smoke. AORN Journal, 87(4), 721–738. doi.org/10.1016/j.aorn.2007.10.012
[3] Control of Smoke From Laser/Electric Surgical Procedures (CDC.gov)
IMAGE
https://www.halton.com/solutions/hospital-ventilation-solutions/gas-and-smoke-extraction/
Back to Blog