The application of the advanced technologies in medicine has led to the appearance of new risk factors for health personnel. One of these could be the surgical smoke produced by electrosurgical instruments, ultrasounds, or lasers. read more
Electrosurgery devices, laser ablation and ultrasonic scalpels are widely recognized as major advances in surgical technology. Electrosurgery is used in more than 85% of 24 million surgeries performed annually in the US. read more
Although electrosurgical technology was developed by Harvey Cushing and William T. Bovie in 19261, "surgical smoke" was not officially recognized as a significant hazard until the National Institute for Occupational Safety and Health (NIOSH) published and distributed a Health Hazard Evaluation Report in 1985. read more
Electrocautery, harmonic scalpel tissue dissection and other surgical techniques can generate surgical smoke with high proportion of "fine particles" (PM2.5) <2.5µ,m, which is known to have adverse effects on human health. read more
Approximately 20 million Americans undergo surgery with general anesthesia each year. Nowadays, electrocautery, laser ablation, and ultrasonic scalpel dissection are widely recognized as major advances in surgical technique and are increasingly being used for tissue cutting and hemostasis. read more
The possibility that laser surgeons might inhale virus particles from laser vapor during the removal of certain lesions has been pointed out by several authors. Human papillomavirus (HPV) is considered to be the most important potential agent for transmission from patient to surgeon through smoke plume from lasers. read more
Smoke created both with laser and electrocautery contain mainly hydrocarbons, nitriles, fatty acids and phenols.2 Of these, formaldehyde, acrolein, mixtures of benzene, toluene, ethylbenzene, xylene (BTEX), and polyaromatic hydrocarbons are of most concern. read more
Each year, an estimated 500,000 healthcare workers –including surgeons, nurses, anesthesiologists and surgical technologists –are exposed to harmful surgical smoke, with potentially quite serious repercussions. More than 150 different chemical constituents have been identified in surgical smoke, some with the capacity for causing human cell damage, cancer and infectious disease. read more
Results of this study demonstrate that aerosolization of malignant cells occurs as a result of application of electrocautery to malignant tissues. These findings lend support to the hypothesis that the higher the incidence of port site recurrence of laparoscopic surgery for malignant disease may be due to implantation of cells in suspension within the electrocautery plume. read more
Carbon dioxide (CO2) lasers are commonly used to excise lesions on the larynx, cervix, lower genital tract, and perianal regions. Tissue destruction from the laser's energy produces a gaseous plume containing cell contents and other aerosols. Many potential risks have been associated with laser plume exposure including the risk of human papillomavirus (HPV) transmission; in vitro experiments have reported HPV transmission through laser plumes. This case report describes, to the author's knowledge, the first cases of HPV-16 positive oropharyngeal squamous cell carcinomas in two surgeons following long-term occupational laser plume exposure. read more