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JSLS


Title:Chemicals in Surgical Smoke and the Efficiency of Built-in-Filter Ports
Author(s):Ha HI; Choi MC; Jung SG; Joo WD; Lee C; Song SH; Park H;
Address:"Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Ilsan, Goyang-si, Republic of Korea. Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea"
Journal Title:JSLS
Year:2019
Volume:23
Issue:4
Page Number: -
DOI: 10.4293/JSLS.2019.00037
ISSN/ISBN:1938-3797 (Electronic) 1086-8089 (Print) 1086-8089 (Linking)
Abstract:"BACKGROUND AND OBJECTIVES: Surgical smoke contains various malodorous and hazardous combustion byproducts. We aimed to analyze hydrocarbons accumulated in the abdominal cavity during laparoscopic gynecologic surgery and determine the efficiency of a built-in-filter port. METHODS: We prospectively followed seven patients with benign uterine pathology. Surgical smoke was generated using laparoscopic or robotic electrocautery. The smoke was collected twice for each patient using a built-in-filter port and a conventional port. The concentrations of volatile organic compounds and aldehydes were determined using gas chromatography with mass spectrometry and high-performance liquid chromatography with ultraviolet visible light detection and compared using the paired-sample Wilcoxon signed-rank test. RESULTS: Five volatile organic compounds and five aldehydes had toxic effects or unpleasant odors. The median concentration of formaldehyde before filtration (0.870 ppm) exceeded the time-weighted average concentration (0.75 ppm) of the Occupational Safety and Health Administration. Built-in-filter ports significantly reduced the concentration of five volatile organic compounds and two aldehydes but not that of formaldehyde, acetaldehyde, and propionaldehyde. Formaldehyde concentration decreased by 50% after filtration but remained above the recommended exposure limit (0.016 ppm) of the National Institute of Occupational Safety and Health. CONCLUSIONS: Surgical smoke in minimally invasive gynecologic procedures contains several hazardous hydrocarbons including formaldehyde. Built-in-filter ports have the potential to reduce the exposure of surgical smoke to surgeons and operating room personnel; nevertheless, development of built-in-filter ports is necessary to improve the filtering efficiency for highly concentrated formaldehydes"
Keywords:Adult Aldehydes/*analysis *Electrocoagulation Female Filtration/*instrumentation Gas Chromatography-Mass Spectrometry Gynecologic Surgical Procedures Humans Laparoscopy Middle Aged Operating Rooms Prospective Studies Smoke/*analysis/prevention & control V;
Notes:"MedlineHa, Hyeong In Choi, Min Chul Jung, Sang Geun Joo, Won Duk Lee, Chan Song, Seung Hun Park, Hyun eng 2019/12/04 JSLS. 2019 Oct-Dec; 23(4):e2019.00037. doi: 10.4293/JSLS.2019.00037"

 
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