2083 IS SURGICAL SMOKE PRODUCED BY COMBINED TRANSURETHRAL RESECTION AND VAPORIZATION OF THE PROSTATE TOXIC TO OPERATING PERSONNELS?

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology II1 Apr 20102083 IS SURGICAL SMOKE PRODUCED BY COMBINED TRANSURETHRAL RESECTION AND VAPORIZATION OF THE PROSTATE TOXIC TO OPERATING PERSONNELS? Chen Zhao, Sae Woong Kim, Myung Ki Kim, and Jong Kwan Park Chen ZhaoChen Zhao Jeonju, Republic of Korea More articles by this author , Sae Woong KimSae Woong Kim Seoul, Republic of Korea More articles by this author , Myung Ki KimMyung Ki Kim Jeonju, Republic of Korea More articles by this author , and Jong Kwan ParkJong Kwan Park Jeonju, Republic of Korea More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2144AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Very toxic byproducts are included in surgical smoke. Surgical smoke is also produced during combined transurethral resection and vaporization of the prostate (CTURVP). We investigated the chemical composition of surgical smoke, which included very explosive and harmful carcinogens to the patient and surgical team. METHODS Smoke was produced in 6 CTURVPs. Smoke samples were collected from a continuous irrigation suction drainage system on Tenax absorbent at a flow rate of 0.05 l/minute. The gases were quantitatively and qualitatively analyzed by gas chromatography-mass spectrometry (GC-MS) equipped with a purge and trap sample injector. RESULTS The main chemical constituents of surgical smoke produced in CTURVPs were propylene, allene, isobutylene, 1,3-butadiene, vinyl acetylene, mecaptomethane, ethyl acetylene, diacetylene, 1-pentene, EtOH, piperylene, propenylacetylene, 1,4-pentadiene, cyclopentadiene, acrylnitrile, and butyrolacton. The amount of 7 components contained in 1 l of gas were as follows: propylene, 0.80 ± 0.52 mg; isobutylene, 212.85 ± 75.65 mg; 1,3-butadiene, 0.93 ± 0.34 mg; ethyl acetylene, 0.09 ± 0.05 mg; 1-pentene, 6.75 ± 1.62 mg; 1,4-pentadiene, 0.06 ± 0.02 mg; and acrylonitrile, 1.62 ± 1.19 mg; 1,3-butadiene, vinyl acetylene, and acrylonitrile are very toxic and known to be carcinogens. CONCLUSIONS A higher quality filter mask, smoke evacuation device, and/or smoke filter should be developed for safety for operating personnel and patients undergoing transurethral resection surgery. Table 1. Qualification data of gas collected by purge & trap GC/MSD Retention time Name Quality score Molecular formula Hazards Flash point 1.64 propylene 97 MeCH=CH2 A F+ 1.74 allene 99 H2C=C=CH2 B,A F++ 1.89 isobutylene 97 Me2C=CH2 B,A F 1.95 1,3-butadiene 97 H2C=CHCH=CH2 D F++ 2.05 vinyl acetylene 90 HC=CCH=CH2 B,A,D F++ 2.14 mercaptomethane 94 MeSH B F++ 2.24 ethylacetylene 94 EtC≡CH A F 2.36 diacethylene 97 HC≡CC≡CH B,A F++ 2.55 1-pentene 85 PrCH=CH2 B F++ 2.72 ethanol 94 EtOH A S 2.83 piperylene 83 H2C=CHCH=CHMe B F+ 3.02 propenylacetylene 84 HC≡CCH=CHMe Nodata Nodata 3.09 1,4-pentadiene 85 H2C=CHCH2CH=CH2 B F+ 3.33 cyclopetadiene 83 C5H6 C S 3.79 acrylonitrile 98 NCCH=CH2 D F++ 4.01 butyrolactone 88 C4H6O2 B S A means central nervous system depression. B means skin, eye, and respiratory irritant. C means toxic to skin, eyes, and respiratory system. D menas human carcinogen. F means flammable. F+ means highly flammable. F++ menas extremely flammable. S means stable. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e810 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chen Zhao Jeonju, Republic of Korea More articles by this author Sae Woong Kim Seoul, Republic of Korea More articles by this author Myung Ki Kim Jeonju, Republic of Korea More articles by this author Jong Kwan Park Jeonju, Republic of Korea More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...