Smoke analysis of a new surgical system that applies low-temperature plasma

Boya Zhang; Qingyu Guan; Yunsheng Zhu; Jingjin Zhu; Xiaohan Liu; Shuaiqi Li; Rungong Yang; Xiru Li

doi:10.21037/atm-22-608

Smoke analysis of a new surgical system that applies low-temperature plasma

Ann Transl Med. 2022 Oct;10(19):1053. doi: 10.21037/atm-22-608.

Authors

Boya Zhang^{1

2}, Qingyu Guan^{1

2}, Yunsheng Zhu², Jingjin Zhu^{1

2}, Xiaohan Liu^{1

2}, Shuaiqi Li^{1

2}, Rungong Yang³, Xiru Li²

Affiliations

¹ School of Medicine, Nankai University, Tianjin, China.
² Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China.
³ Department of Tissue Repair and Regeneration, Chinese People's Liberation Army General Hospital, Beijing, China.

Abstract

Background: The high-frequency electrotome (ES), which is widely used in surgical procedures, generates surgical smoke that is potentially hazardous to operating personnel. Previous research shows that the PlasmaBlade (PB) may be able to overcome this problem. The present study set out to analyze potentially hazardous surgical smoke generated during electrosurgery by the ES, the PB, and. a new surgical system that applies low-temperature plasma, the NTS-100.

Methods: In vitro and in vivo healthy porcine models were used to compare volatile organic compounds (VOCs) and particulate matter (PM) in smoke generated by the NTS-100, the PB, and the conventional ES when cutting liver, muscle, and skin and subcutaneous tissues. The detected indexes included the VOCs in surgical smoke, the concentration and percentage of each part, the PM2.5 concentration, the mass of particles, and the diameter distribution of particles.

Results: The smoke generated by the NTS-100 contained fewer hazardous components than that generated by the ES (P<0.05) and a comparable amount to that generated by the PB (P>0.05). The PM2.5 concentration and mass of particles in the smoke generated by the NTS-100 were lower than those with the ES (P<0.05 and P<0.01, respectively) and similar to those with the PB (P>0.05). The NTS-100 generated larger particles than did the ES and the PB (P<0.05).

Conclusions: Surgical smoke contains harmful VOCs and PM, but the NTS-100 generated less hazardous surgical smoke than did the conventional ES and performed comparably to the PB. Therefore, using the NTS-100 may reduce the potential hazard of surgical smoke to operating room personnel.

Keywords: High-frequency electrotome; PlasmaBlade (PB); low-temperature plasma; surgical smoke.