Surgical smoke plume is generated during laser and electro-surgical procedures as tissue is ablated or cauterized with thermal tools. As a professional in the healthcare industry, you have most likely seen or smelled surgical smoke during procedures.

What is it?

Surgical smoke plume is a potentially dangerous by-product generated from the use of lasers, electro-surgical pencils, ultrasonic devices, and other surgical instruments. As these instruments cauterize vessels and destroy (vaporize) tissue, fluid, and blood they create a gaseous material known as smoke plume. The amount, content, and particulate size of smoke plume can vary depending on the type of thermal tool used. In general lasers and ultrasonic devices have been known to create the largest particles (commonly called "plume"); electro-surgical pencils have been known to create the smallest particles. With regards to ultrasonic devices, it is important to note that while the manufacturer indicates this device produces a vapor, not smoke, these cool aerosols have an even higher chance of carrying infectious and live materials when compared to laser and electro surgical byproducts. Therefore as a general rule, smaller particles are considered more troublesome from a chemical standpoint, while larger particles are considered more troublesome from a biological standpoint.

Why evacuate it?

There are several reasons to evacuate surgical smoke:

Surgical smoke creates visibility problems during minimally invasive procedures and procedures where there is a lot of tissue ablation. This slows down surgical time, and could potentially increase the risk for complications. Additionally, removal of aerosols in the peritoneal cavity have shown to help reduce build up on camera lenses.

Research regarding surgical smoke produced from electrosurgery is simular in content to the smoke that is produced by surgical lasers. Viable viruses and bacteria, blood and blood fragments, and carcinogens and neurotoxic componds (ex. benzene, hydrogen sulfid, toluene) are known to be in electrosurgical smoke. It is these hazards that the operating room staff are continually exposed to as they breathe.

Additionally, surgical smoke plume has shown the potential to have adverse negative effects on the patient when plume is not properly evacuated during laparoscopic/ endoscopic procedures.

Are there any health risks?

The primary health risk is inhalation of surgical smoke. Surgical smoke contains particulate, organic & inorganic chemicals, and microorganisms. Twenty seven (27) different chemicals have been isolated from pryrolized smoke plume/aersol including chemicals such as benzene, toluene, formaldehyde, cyanide, PAHs, carbon monoxide and acrolein. Many of these are found in cigarette smoke. The information in this section will outline the contents of plume and how each of these components can adversely impact healthcare workers' safety.

Article Library

Buffalo Filter has been committed to providing education about the hazards of surgical smoke for over a decade. Buffalo Filter's web-site is host to a bibliography of more than 150 articles of research, studies, and editorial work discussing the hazards of surgical smoke. Some of these articles discuss procedures that utilize devices such as: Lasers, Electrosurgical devices, Ultrasonic Scalpels, and other surgical instruments create hazardous smoke plumes during surgery.

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