Abstract
BackgroundDissection during laparoscopic surgery produces smoke containing potentially toxic substances. The aim of the present study was to analyze smoke samples produced during laparoscopic colon surgery using a bipolar vessel sealing device (LigaSure™).MethodsFour consecutive patients undergoing left-sided colectomy were enrolled in this pilot study. Smoke was produced by the use of LigaSure™. Samples (5,5l) were evacuated from the pneumoperitoneum in a closed system into a reservoir. Analysis was performed with CO2-laser-based photoacoustic spectroscopy and confirmed by a Fourier-transform infrared spectrum. The detected spectra were compared to the available spectra of known toxins.ResultsSamples from four laparoscopic sigmoid resections were analyzed. No relevant differences were noted regarding patient and operation characteristics. The gas samples were stable over time proven by congruent control measurements as late as 24 h after sampling. The absorption spectra differed considerably between the patients. One broad absorption line at 100 ppm indicating H2O and several unknown molecules were detected. With a sensitivity of alpha min ca 10-5 cm-1 no known toxic substances like phenol or indole were identified.ConclusionThe use of a vessel sealing device during laparoscopic surgery does not produce known toxic substances in relevant quantity. Further studies are needed to identify unknown molecules and to analyze gas emission under various conditions.
Highlights
Dissection during laparoscopic surgery produces smoke containing potentially toxic substances
The composition of surgical smoke produced by laparoscopic surgery is likely to be different compared to open surgery, as procedures are performed in a CO2 atmosphere [4,6]
Samples for the presented pilot study were obtained from four consecutive patients randomized to be operated by use of LigaSureTM
Summary
Dissection during laparoscopic surgery produces smoke containing potentially toxic substances. The aim of the present study was to analyze smoke samples produced during laparoscopic colon surgery using a bipolar vessel sealing device (LigaSureTM). Bipolar vessel sealing devices (LigaSureTM) are frequently used in laparoscopic surgery for secure hemostasis, fast dissection and limited collateral tissue damage [1,2]. Smoke is produced by the combustion of organic tissue [3,4,5]. During laparoscopic surgery a specific danger arises for the patient because potentially toxic substances are generated in high concentrations (closed system) in the (page number not for citation purposes). The composition of surgical smoke produced by laparoscopic surgery is likely to be different compared to open surgery, as procedures are performed in a CO2 atmosphere [4,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
