A single-blind controlled study of electrocautery and ultrasonic scalpel smoke plumes in laparoscopic surgery

@article{Fitzgerald2011ASC,
  title={A single-blind controlled study of electrocautery and ultrasonic scalpel smoke plumes in laparoscopic surgery},
  author={James Edward Frankland Fitzgerald and Momin Malik and Irfan Ahmed},
  journal={Surgical Endoscopy},
  year={2011},
  volume={26},
  pages={337-342}
}
BackgroundSurgical smoke containing potentially carcinogenic and irritant chemicals is an inevitable consequence of intraoperative energized dissection. Different energized dissection methods have not been compared directly in human laparoscopic surgery or against commonly encountered pollutants. This study undertook an analysis of carcinogenic and irritant volatile hydrocarbon concentrations in electrocautery and ultrasonic scalpel plumes compared with cigarette smoke and urban city air… 
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References

SHOWING 1-10 OF 14 REFERENCES
Chemical composition of smoke produced by high-frequency electrosurgery
TLDR
The presence of irritant, carcinogenic and neurotoxic compounds in electrosurgical smoke is demonstrated, which may have considerable implications for the health and safety of all involved in surgical practice, as exposure to these compounds pose potential risks to health.
Surgical smoke management for minimally invasive (micro)endoscopy: an experimental study
TLDR
Surgical smoke evacuation from very small endoscopic cavities using microports as small as 20 G (0.9 mm) in diameter may be safe and efficient if sufficient gas exchange is provided during smoke generation by laser or electrosurgical instruments.
Carboxyhemoglobinemia due to peritoneal smoke absorption from laser tissue combustion at laparoscopy.
  • D. Ott
  • Medicine
    Journal of clinical laser medicine & surgery
  • 1998
TLDR
The laser smoke group showed a statistically significantly elevated peripheral blood COHb levels, a significant increase in intra-abdominal CO concentration, and a lack of correlation of pulse oximetry and blood oxygen saturation experiments.
Chemical composition of surgical smoke produced by electrocautery, harmonic scalpel and argon beaming – a short study
TLDR
Surgical smoke contains toxic, partly cancerogenic compounds and the exposition to surgical 'smog' should be minimised at any time using offtake devices.
Cytotoxicity of electro-surgical smoke produced in an anoxic environment.
Current attitudes and practices towards diathermy smoke.
TLDR
Only 3 of 98 surgeons used dedicated smoke extractors, despite the fact the majority felt that, currently, inadequate precautions were taken to protect staff and patients from surgical smoke.
CO2 laser-photoacoustic analysis of smoke emitted during minimal invasive electro-knife surgery
Abstract.Smoke samples produced by colorectral laparoscopic operations have been studied with a 13CO2 laser-based photoacoustic spectrometer. The most difficult problem was the existence of almost
Mutagenicity of smoke condensates induced by CO2-laser irradiation and electrocauterization.
Smoke condensates generated from mucous membrane of the canine tongue irradiated with a CO2 laser showed mutagenicity on Salmonella typhimurium TA98 under metabolic activation with S9 mix. Strain
...
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