The results of research conducted at the University of Tampere and Tampere University of Technology (TUT) demonstrate that different types of tissue produce different quantities of surgical smoke during electrosurgery. All the current protective measures do not adequately protect operating room personnel from small particles contained in the smoke.
Electrosurgical scalpels are routinely used to perform surgical operations. In electrosurgery, electrical current passes through tissue to cut or cauterize it. Grounding pads are utilized for a safe return of electrosurgical energy from the patient's body. The surgical smoke generated in the process contains small particles that are harmful to human health.
“Tiny particles that are able to penetrate deep into the lungs and up to the alveoli are especially harmful. They can pass through the lungs into the bloodstream. Frequent exposure to small particles is associated with an increased susceptibility to respiratory disorders, cancer and vascular diseases,” says Markus Karjalainen, who is working towards a doctoral degree at TUT.
Special filters have been developed to block similar particles produced by diesel engines. Effective respirators or advanced smoke evacuation systems can prevent the inhalation of harmful small particles in operating rooms. Conventional surgical masks offer little protection from small particles.
Surgical smoke evacuation systems into routine use
In the joint project between the University of Tampere and Tampere University of Technology, Markus Karjalainen explored the composition of surgical smoke and the fine particulate matter produced while cutting different types of tissue. Published in the Plos One journal, the results demonstrate that the quantity of small particles released into the air during surgery varies widely depending on the type of tissue.
“The types of tissue can be divided into three distinct risk categories. Liver tissue falls into the high-risk category, as it releases a quantity of particulate matter that is many times that produced by low-risk fat tissue. Among others, muscle and renal tissue fall halfway between the two extremes,” describes Karjalainen.
For example, the amount of particles produced when cutting liver tissue exceeds the safe threshold even if the operating room is equipped with a smoke evacuator. Conventional surgical suction systems that remove liquids result in particle exposure that is four times higher than the safe threshold. The exposure is eight times higher without any smoke evacuation system.
“While cutting medium-risk tissue, surgeons are exposed to harmful levels of small particles if no smoke evacuation system is used. However, it is not safe to cut even low-risk tissue without some type of smoke removal. Proper smoke evacuation units are still not utilized in the majority of procedures, although they are widely used especially in plastic surgery,” says Karjalainen.
The inhalation of one gram of surgical smoke is estimated to be equivalent to smoking six unfiltered cigarettes. This means that the exposure to surgical smoke during a single operation is equal to passively smoking more than a pack of cigarettes.
“A great deal of effort has been made to protect restaurant workers from occupational exposure to second-hand smoke. Surely, surgical staff are also entitled to protection from occupational hazards that would be intolerable in any other sector,” comments Doctor of Medicine Antti Roine, one of the masterminds behind the research idea.
Read more about the research in Plos One
Markus Karjalainen, tel. +358 408 281 085, firstname.lastname@example.org
Antti Roine, tel. +358 408 410 698, email@example.com