Risk mitigation to healthcare workers against viral and bacterial bioaerosol load in laparoscopic surgical exhaust with a new flow mode in hollow fiber membranes-based filter.

Abstract

Laparoscopy of COVID-19-infected/suspected patients needs to be performed with the utmost care due to the chances of virus carryover through the pneumoperitoneum gas. In this study, polysulfone/polyvinyl-pyrrolidone hollow fiber membranes (HFMs) were fabricated by phase inversion process, and these HFMs were bundled into a module consisting of tortuous, circular-helical arrangement. Further, copper (Cu) and zinc (Zn) nanoparticles (NPs), known to have antimicrobial and antiviral properties, were flow-coated on the lumen side of the HFMs. To test functional efficiency, the modules were challenged with wet aerosol and bioaerosols. Wet aerosol removal efficiency was ∼98%. Bioaerosol-containing bacteria E. coli strain K-12, showed 2.6log (∼99.8%), and 2.1log (∼99.3%) removal efficiency for Cu NPs and Zn NPs coated HFMs modules, respectively, and 1.6log (∼97%) removal for plain (uncoated) HFMs. Bioaerosols containing SARS-CoV-2 surrogate virus (MS2 bacteriophage) showed ∼5-7log reduction of bacteriophage for plain HFMs, 3.9log, and 2.3log reduction for Cu and Zn coated HFMs, respectively. The flow of aerosols entirely through the HFM lumen helps in attaining a low ΔP of <1mm Hg, thus rendering its usefulness, particularly for exhausting pneumoperitoneum gases where high upstream pressures could lead to barotrauma. STATEMENT OF ENVIRONMENTAL IMPLICATION: Surgical smoke is generated during minimally invasive surgical (MIS) procedure such as laparoscopy when electrosurgical devices are used to cut any tissues. This smoke is a hazard as it contains toxic volatile compounds, mutagens, carcinogens, bacteria, and virus-laden aerosols. Infection to healthcare professionals through the bioaerosols containing smoke is well reported in literature. The limitation of using hypochlorite and pleated/HEPA filter, led us to design a low pressure drop bioaerosol filter, which can remove smoke, tissue fragments, and COVID-19 virus. It provides a much safer operation theatre environment during MIS procedures as well as in general for bioaerosol removal.