Comparison of surgical smoke between open surgery and laparoscopic surgery for colorectal disease in the COVID-19 era

Abstract

Background: Surgical smoke during operation is a well-known health hazard for medical staff. This study aimed to investigate the dynamics of surgical smoke during open surgery or laparoscopic surgery for colorectal disease.

Methods: This study quantitated particulate matter (PM) counts as part of surgical smoke in 31 consecutive patients who underwent colectomy at the Niigata City General Hospital using a laser particle counter. Particles were graded by size as ≤ 2.5 μm PM (PM_2.5) or > 2.5 μm PM (large PM). Operative procedures were categorized as either open surgery (n = 14) or laparoscopic surgery (n = 17).

Results: The median patient age was 72 (range 41-89) years and 58.1% were male. The total PM_2.5, PM_2.5 per hour, and maximum PM_2.5 per minute counts during operation were significantly higher in open surgery than in laparoscopic surgery (P = 0.001, P < 0.001, and P = 0.029, respectively). Large PM counts (total, per hour, and maximum per minute) were also higher in the open surgery group than in the laparoscopic surgery group. The maximum PM_2.5 concentration recorded was 38.6 µm/m³, which is considered "unhealthy for sensitive groups" according to the U.S. Environment Protection Agency air quality index standards, if it was a 24-h period mean value.

Conclusion: Exposure to surgical smoke is lower during laparoscopic surgery than during open surgery for colorectal diseases.

Keywords: Laparoscopic surgery; Open surgery; Particulate matter; Surgical smoke.