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. 2008 Dec 3:3:31.
doi: 10.1186/1745-6673-3-31.

Surgical smoke and ultrafine particles

Irene Brüske-Hohlfeld #  1 , Gerhard Preissler #  2 , Karl-Walter Jauch  2 , Mike Pitz  1   3 , Dennis Nowak  4 , Annette Peters  1 , H-Erich Wichmann  1   5
Affiliations

Surgical smoke and ultrafine particles

Irene Brüske-Hohlfeld et al. J Occup Med Toxicol. .

Abstract

Background: Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine (<100 nm) and accumulation mode particles (< 1 mum). Epidemiological and toxicological studies have shown that exposure to particulate air pollution is associated with adverse cardiovascular and respiratory health effects.

Methods: To measure the amount of generated particulates in 'surgical smoke' during different surgical procedures and to quantify the particle number concentration for operation room personnel a condensation particle counter (CPC, model 3007, TSI Inc.) was applied.

Results: Electro-cauterization and argon plasma tissue coagulation induced the production of very high number concentration (> 100000 cm-3) of particles in the diameter range of 10 nm to 1 mum. The peak concentration was confined to the immediate local surrounding of the production side. In the presence of a very efficient air conditioning system the increment and decrement of ultrafine particle occurrence was a matter of seconds, with accumulation of lower particle number concentrations in the operation room for only a few minutes.

Conclusion: Our investigation showed a short term very high exposure to ultrafine particles for surgeons and close assisting operating personnel - alternating with longer periods of low exposure.

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Figures

Figure 1
Figure 1
Comparison of particle number concentration measured with the CPC3007 and calculated from the particle size distribution of a TDMPS/APS system.
Figure 2
Figure 2
Comparison of particle number concentration measured with two identical CPC3007.
Figure 3
Figure 3
Local relapse of a retroperitoneal sarcoma; adhesiolysis and removal of the tumor.
Figure 4
Figure 4
Hemangioma of the liver; hemihepatectomy.
Figure 5
Figure 5
Retroperitoneal tumor; removal of the tumor.
Figure 6
Figure 6
Incisional hernia; mesh hernia repair.
Figure 7
Figure 7
Benign bile duct stenosis; adhesiolysis, biliodigestive anastomosis.
Figure 8
Figure 8
Chronic appendicitis; laparoscopic appendectomy.
See this image and copyright information in PMC

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