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Médecine du travail du personnel hospitalier

Health risk to medical personnel of surgical smoke produced during laparoscopic surgery

Auteur       Miłosz Dobrogowski
Auteur       Wiktor Wesolowski
Auteur       Małgorzata Kucharska
Auteur       Katarzyna Paduszyńska
Auteur       Agnieszka Dworzyńska
Auteur       Wiesław Szymczak
Auteur       Andrzej Sapota
Auteur       Lech Pomorski
Volume       28
Numéro       5
Pages       831-840
Publication       International Journal of Occupational Medicine and Environmental Health
ISSN       1896-494X
Date       2015
Résumé       OBJECTIVES: During laparoscopic cholecystectomy, the removal of the gall bladder, pyrolysis occurs in the peritoneal cavity. Chemical substances which are formed during this process escape into the operating room through trocars in the form of surgical smoke. The aim of this study was to identify and quantitatively measure a number of selected chemical substances found in surgical smoke and to assess the risk they carry to medical personnel. MATERIAL AND METHODS: The study was performed at the Maria Skłodowska-Curie Memorial Provincial Specialist Hospital in Zgierz between 2011 and 2013. Air samples were collected in the operating room during laparoscopic cholecystectomy. RESULTS: A complete qualitative and quantitative analysis of the air samples showed a number of chemical substances present, such as aldehydes, benzene, toluene, ethylbenzene, xylene, ozone, dioxins and others. CONCLUSIONS: The concentrations of these substances were much lower than the hygienic standards allowed by the European Union Maximum Acceptable Concentration (MAC). The calculated risk of developing cancer as a result of exposure to surgical smoke during laparoscopic cholecystectomy is negligible. Yet it should be kept in mind that repeated exposure to a cocktail of these substances increases the possibility of developing adverse effects. Many of these compounds are toxic, and may possibly be carcinogenic, mutagenic or genotoxic. Therefore, it is necessary to remove surgical smoke from the operating room in order to protect medical personnel.

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