Aerosols, airflow, and airspace contamination during laparoscopy

Abstract

Laparoscopic surgery has been undermined throughout the COVID-19 pandemic by concerns that it may generate an infectious risk to the operating team through aerosolization of peritoneal particles. There is anyway a need for increased awareness and understanding of the occupational hazard for surgical teams regarding unfiltered escape of pollutants generated by surgical smoke and other microbials. Here, the aerosol-generating nature of this access modality was confirmed through repeatable real-time methodology both qualitatively and quantitively to inform best practice and additional engineering solutions to optimize the operating room environment.

Fig. 1

Comet plot images (maximum-averaged stack of sequential 12-bit Raw frames of intraoperative footage) showing particles including trajectories as repeated particle groups in the operative airspace during (a) dissection of the gallbladder from the liver bed during cholecystectomy (b) with the laparoscopic port luer lock open to vent intrabdominal smoke and (c) on specimen extraction via a periumbilical incision (imagery best appreciated by viewing the associated video).