Lin Xiaosong, Fan Qiming, Li Renjie, Chen Ruijian, Yang Zifeng, Li Yong
Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Department of Gastrointestinal Surgery, Jieyang People's Hospital, Jieyang, 522000, China.
Biomed Eng Online. 2025 May 26;24(1):65. doi: 10.1186/s12938-025-01395-4.
Particulate matter (PM) in surgical smoke is known to influence operative vision and poses safety risks to operating personnel. Nebulization, which is effective in promoting the deposition of PM, has not been used to clear laparoscopic surgical smoke.
The novel nebulizer was tested for mechanical characteristics and applied to evaluate its feasibility for surgical smoke clearance. Nebulization (n = 6) or elimination (n = 6) procedures were performed to manage surgical smoke produced by electrocautery hook or ultrasonic scalpel on various tissues of twelve rabbits. Levels of PM in surgical smoke, including the PM1.0, PM2.5, PM10, and total suspended particulate were compared to evaluate emissions from both surgical instruments. In addition, pre-treatment, post-treatment and reduction in PM concentrations were compared between the nebulization and elimination groups.
The spray cone angle was approximately 70°, and the median particle size was around 25 µm. Laparoscopic visibility was restored with clearance of surgical smoke within 8 s after nebulization. The electrocautery hook produced significantly higher levels of PM compared to the ultrasonic scalpel. The PM concentrations generated by electrocautery hook varied across different tissues, whereas only PM1.0 level differed with the ultrasonic scalpel. The pre-treatment PM concentrations were comparable between both groups. The nebulization group showed a greater reduction in PM concentrations compared to the elimination group, with statistical significance in PM1.0 levels. Consequently, post-treatment PM concentrations were significantly lower in the nebulization group. Similar trends were observed across all target tissues except for omentum.
Nebulization was an effective method for clearing laparoscopic surgical smoke thereby improving surgical vision and potentially mitigating risks associated with surgical smoke exposure.
已知手术烟雾中的颗粒物（PM）会影响手术视野，并对手术人员构成安全风险。雾化在促进PM沉积方面有效，但尚未用于清除腹腔镜手术烟雾。
对新型雾化器进行机械特性测试，并应用于评估其清除手术烟雾的可行性。对12只兔子的各种组织使用电灼钩或超声刀产生手术烟雾，进行雾化（n = 6）或清除（n = 6）操作。比较手术烟雾中PM1.0、PM2.5、PM10和总悬浮颗粒物的水平，以评估两种手术器械的排放情况。此外，比较雾化组和清除组之间PM浓度的预处理、后处理及降低情况。
喷雾锥角约为70°，中位粒径约为25μm。雾化后8秒内手术烟雾清除，腹腔镜视野恢复。与超声刀相比，电灼钩产生的PM水平显著更高。电灼钩产生的PM浓度在不同组织间有所不同，而超声刀仅PM1.0水平存在差异。两组的预处理PM浓度相当。与清除组相比，雾化组的PM浓度降低幅度更大，在PM1.0水平上具有统计学意义。因此，雾化组的后处理PM浓度显著更低。除网膜外，在所有目标组织中均观察到类似趋势。
雾化是清除腹腔镜手术烟雾的有效方法，从而改善手术视野并可能降低与手术烟雾暴露相关的风险。
