Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Erbe Elektromedizin GmbH, Tuebingen, Germany.
Interact Cardiovasc Thorac Surg. 2022 May 2;34(5):775-782. doi: 10.1093/icvts/ivac024.
Evaluation of smoke capture efficiency of different mobile smoke evacuation devices with respect to volatile organic compounds and their noise emission.
Electrosurgical incisions were performed on fresh porcine liver in an operating room with vertical laminar flow. The generated surgical smoke was analysed with proton-transfer-reaction mass spectrometry with and without the use of a mobile smoke evacuation system consisting of a smoke evacuator machine, a suction hose and a handpiece. The inlet of the mass spectrometer was positioned 40 cm above the specimen. Various devices were compared: a hard plastic funnel, a flexible foam funnel, an on-tip integrated aspirator of an electrosurgical knife and a standard secretion suction (Yankauer). Also, sound levels were measured at a distance of 40 cm from the handpieces' inlet.
The smoke capture efficiency of the secretion suction was only 53%, while foam funnel, plastic funnel and integrated aspirator were all significantly more effective with a clearance of 95%, 91% and 91%, respectively. The mean sound levels were 68 and 59 A-weighted decibels with the plastic and foam funnel, respectively, 66 A-weighted decibels with the integrated aspirator and 63 A-weighted decibels with the secretion suction.
Carcinogenic, mutagenic and reprotoxic volatile organic compounds in surgical smoke can be efficiently reduced by mobile smoke evacuation system, providing improved protection for medical personnel. Devices specifically designed for smoke evacuation are more efficient than standard suction tools. Noise exposure for the surgeon was lowest with the flexible foam funnel and higher with the other handpieces tested.
评估不同移动烟雾清除设备对挥发性有机化合物的捕获效率及其噪声排放。
在垂直层流的手术室中对新鲜猪肝进行电外科切割。使用质子转移反应质谱法，在使用和不使用由烟雾清除器、吸气管和手柄组成的移动烟雾清除系统的情况下分析产生的手术烟雾。质谱仪的入口位于标本上方 40cm 处。比较了各种设备：硬塑料漏斗、柔性泡沫漏斗、电外科刀的尖端集成抽吸器和标准分泌物抽吸器（吸引器）。此外，还在距手柄入口 40cm 处测量了声级。
分泌物抽吸的烟雾捕获效率仅为 53%，而泡沫漏斗、塑料漏斗和集成抽吸器的清除率分别为 95%、91%和 91%，均显著更高。塑料和泡沫漏斗的平均声级分别为 68 和 59 A 加权分贝，集成抽吸器为 66 A 加权分贝，分泌物抽吸器为 63 A 加权分贝。
移动烟雾清除系统可有效减少手术烟雾中的致癌、致突变和生殖毒性挥发性有机化合物，为医务人员提供更好的保护。专门设计用于烟雾清除的设备比标准抽吸工具更有效。外科医生的噪声暴露最低的是柔性泡沫漏斗，而其他测试的手柄则较高。
