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Efficient Viral & Smoke Filtration During Laparoscopic Surgery

Is surgical smoke a risk for viral infection in minimally invasive surgery?

Minimally Invasive surgery often includes the use of electrosurgical procedures, which leads to the production of smoke and aerosols. Clinical and laboratory studies have shown that surgical smoke may contain viable viruses, a fact, which raises concerns about possible infections from desufflation gases, a particularly relevant concern during the COVID–19 pandemic1.

 

In that context, the European Society of Gastrointestinal Endoscopy states that there is currently no data on the presence of Covid–19 in surgical smoke, but this is a possibility. Risks of smoke inhalation to surgeons and staff when carrying out laparoscopic surgery has been documented. Assuming the SARS–CoV–2 virus could be present within the body cavity of the patient being operated upon, there would be a risk to staff, increased beyond that for an open operation2.

 

To avoid the risk of smoke inhalation and potential SARS–CoV–2 transmission, several national and international societies recommend surgical smoke filtration in response to the COVID–19 crisis.

 

For example, in their joint statement the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and the European Association of Endoscopic Surgery (EAES) (SAGES and EAES recommendations regarding surgical response to COVID–19 crisis) recommend that “all pneumoperitoneum should be safely evacuated via a filtration system before closure, trocar removal, specimen extraction or conversion to open.”3

 

You may download the overview “CORONAVIRUS DISEASE (COVID–19): Recommendations of surgical smoke filtration systems in response to covid–19 crisis” in order to obtain further up to date statements from national and international organisations with regards to the usage of smoke filtration systems in the COVID–19 crisis.

 

REFERENCES: 

  1. https://www.cdc.gov/niosh/topics/healthcarehsps/smoke.html
  2. https://esge.org/wp-content/uploads/2020/03/Covid19StatementESGE.pdf
  3. https://www.sages.org/recommendations–surgical–response–covid–19/
  4. Pall Scientific Laboratory Services Technical Report 2001
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