Safe management of surgical smoke in the age of COVID‐19
Background The COVID‐19 global pandemic has resulted in a plethora of guidance and opinion from surgical societies. A controversial area concerns the safety of surgically created smoke and the perceived potential higher risk in laparoscopic surgery. Methods The limited published evidence was analyse...
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| Veröffentlicht in: | British journal of surgery 2020-10, Vol.107 (11), p.1406-1413 |
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| container_title | British journal of surgery |
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| creator | Mowbray, N. G. Ansell, J. Horwood, J. Cornish, J. Rizkallah, P. Parker, A. Wall, P. Spinelli, A. Torkington, J. |
| description | Background
The COVID‐19 global pandemic has resulted in a plethora of guidance and opinion from surgical societies. A controversial area concerns the safety of surgically created smoke and the perceived potential higher risk in laparoscopic surgery.
Methods
The limited published evidence was analysed in combination with expert opinion. A review was undertaken of the novel coronavirus with regards to its hazards within surgical smoke and the procedures that could mitigate the potential risks to healthcare staff.
Results
Using existing knowledge of surgical smoke, a theoretical risk of virus transmission exists. Best practice should consider the operating room set‐up, patient movement and operating theatre equipment when producing a COVID‐19 operating protocol. The choice of energy device can affect the smoke produced, and surgeons should manage the pneumoperitoneum meticulously during laparoscopic surgery. Devices to remove surgical smoke, including extractors, filters and non‐filter devices, are discussed in detail.
Conclusion
There is not enough evidence to quantify the risks of COVID‐19 transmission in surgical smoke. However, steps can be undertaken to manage the potential hazards. The advantages of minimally invasive surgery may not need to be sacrificed in the current crisis.
The COVID‐19 pandemic is unprecedented and raises concerns regarding transmission of the virus within surgical smoke. This review summarizes the current evidence and provides advice for its management.
Bad for your health? |
| doi_str_mv | 10.1002/bjs.11679 |
| format | Article |
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The COVID‐19 global pandemic has resulted in a plethora of guidance and opinion from surgical societies. A controversial area concerns the safety of surgically created smoke and the perceived potential higher risk in laparoscopic surgery.
Methods
The limited published evidence was analysed in combination with expert opinion. A review was undertaken of the novel coronavirus with regards to its hazards within surgical smoke and the procedures that could mitigate the potential risks to healthcare staff.
Results
Using existing knowledge of surgical smoke, a theoretical risk of virus transmission exists. Best practice should consider the operating room set‐up, patient movement and operating theatre equipment when producing a COVID‐19 operating protocol. The choice of energy device can affect the smoke produced, and surgeons should manage the pneumoperitoneum meticulously during laparoscopic surgery. Devices to remove surgical smoke, including extractors, filters and non‐filter devices, are discussed in detail.
Conclusion
There is not enough evidence to quantify the risks of COVID‐19 transmission in surgical smoke. However, steps can be undertaken to manage the potential hazards. The advantages of minimally invasive surgery may not need to be sacrificed in the current crisis.
The COVID‐19 pandemic is unprecedented and raises concerns regarding transmission of the virus within surgical smoke. This review summarizes the current evidence and provides advice for its management.
Bad for your health?</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.11679</identifier><identifier>PMID: 32363596</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>COVID-19 - prevention & control ; COVID-19 - transmission ; Humans ; Infection Control - instrumentation ; Infection Control - methods ; Infectious Disease Transmission, Patient-to-Professional - prevention & control ; Laparoscopy ; Laparoscopy - adverse effects ; Laparoscopy - instrumentation ; Laparoscopy - methods ; Minimally invasive surgery ; Review ; Smoke - adverse effects ; Surgery</subject><ispartof>British journal of surgery, 2020-10, Vol.107 (11), p.1406-1413</ispartof><rights>2020 The Authors. published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.</rights><rights>2020 The Authors. British Journal of Surgery published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 The Authors. published by John Wiley & Sons Ltd on behalf of BJS Society Ltd. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5039-d3932cff4f47e2785449df60c31de16ed1dd1c40c5830c30521aefc17a96245a3</citedby><orcidid>0000-0001-9931-0145 ; 0000-0002-1493-1768 ; 0000-0002-9302-1761 ; 0000-0002-3218-0574</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.11679$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.11679$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32363596$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mowbray, N. G.</creatorcontrib><creatorcontrib>Ansell, J.</creatorcontrib><creatorcontrib>Horwood, J.</creatorcontrib><creatorcontrib>Cornish, J.</creatorcontrib><creatorcontrib>Rizkallah, P.</creatorcontrib><creatorcontrib>Parker, A.</creatorcontrib><creatorcontrib>Wall, P.</creatorcontrib><creatorcontrib>Spinelli, A.</creatorcontrib><creatorcontrib>Torkington, J.</creatorcontrib><title>Safe management of surgical smoke in the age of COVID‐19</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background
The COVID‐19 global pandemic has resulted in a plethora of guidance and opinion from surgical societies. A controversial area concerns the safety of surgically created smoke and the perceived potential higher risk in laparoscopic surgery.
Methods
The limited published evidence was analysed in combination with expert opinion. A review was undertaken of the novel coronavirus with regards to its hazards within surgical smoke and the procedures that could mitigate the potential risks to healthcare staff.
Results
Using existing knowledge of surgical smoke, a theoretical risk of virus transmission exists. Best practice should consider the operating room set‐up, patient movement and operating theatre equipment when producing a COVID‐19 operating protocol. The choice of energy device can affect the smoke produced, and surgeons should manage the pneumoperitoneum meticulously during laparoscopic surgery. Devices to remove surgical smoke, including extractors, filters and non‐filter devices, are discussed in detail.
Conclusion
There is not enough evidence to quantify the risks of COVID‐19 transmission in surgical smoke. However, steps can be undertaken to manage the potential hazards. The advantages of minimally invasive surgery may not need to be sacrificed in the current crisis.
The COVID‐19 pandemic is unprecedented and raises concerns regarding transmission of the virus within surgical smoke. This review summarizes the current evidence and provides advice for its management.
Bad for your health?</description><subject>COVID-19 - prevention & control</subject><subject>COVID-19 - transmission</subject><subject>Humans</subject><subject>Infection Control - instrumentation</subject><subject>Infection Control - methods</subject><subject>Infectious Disease Transmission, Patient-to-Professional - prevention & control</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - instrumentation</subject><subject>Laparoscopy - methods</subject><subject>Minimally invasive surgery</subject><subject>Review</subject><subject>Smoke - adverse effects</subject><subject>Surgery</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNpVUctOwzAQtBCIlsKBH0CROKf12o5dc0CC8iqq1EOBq-U6dpuSR0kaUG98At_Il-A-qOC0q5nR7GgHoVPAbcCYdMazqg3AhdxDTaA8Cgnw7j5qYoxFCJTQBjqqqhnGQHFEDlHDQ5xGkjfRxUg7G2Q61xOb2XwRFC6o6nKSGJ0GVVa82iDJg8XUBl6wInvDl_7N9-cXyGN04HRa2ZPtbKHnu9un3kM4GN73e1eD0ESYyjCmkhLjHHNMWCK6EWMydhwbCrEFbmOIYzAMm6hLPegDgrbOgNCSExZp2kKXG995Pc5sbHzKUqdqXiaZLpeq0In6z-TJVE2KdyUIF1QKb3C-NSiLt9pWCzUr6jL3mRVhjAjBKKNedfb3zM7_91de0NkIPpLULnc8YLUqQfkS1LoEdf04Wi_0B_zzeFc</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Mowbray, N. G.</creator><creator>Ansell, J.</creator><creator>Horwood, J.</creator><creator>Cornish, J.</creator><creator>Rizkallah, P.</creator><creator>Parker, A.</creator><creator>Wall, P.</creator><creator>Spinelli, A.</creator><creator>Torkington, J.</creator><general>John Wiley & Sons, Ltd</general><general>Oxford University Press</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9931-0145</orcidid><orcidid>https://orcid.org/0000-0002-1493-1768</orcidid><orcidid>https://orcid.org/0000-0002-9302-1761</orcidid><orcidid>https://orcid.org/0000-0002-3218-0574</orcidid></search><sort><creationdate>202010</creationdate><title>Safe management of surgical smoke in the age of COVID‐19</title><author>Mowbray, N. G. ; Ansell, J. ; Horwood, J. ; Cornish, J. ; Rizkallah, P. ; Parker, A. ; Wall, P. ; Spinelli, A. ; Torkington, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5039-d3932cff4f47e2785449df60c31de16ed1dd1c40c5830c30521aefc17a96245a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>COVID-19 - prevention & control</topic><topic>COVID-19 - transmission</topic><topic>Humans</topic><topic>Infection Control - instrumentation</topic><topic>Infection Control - methods</topic><topic>Infectious Disease Transmission, Patient-to-Professional - prevention & control</topic><topic>Laparoscopy</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - instrumentation</topic><topic>Laparoscopy - methods</topic><topic>Minimally invasive surgery</topic><topic>Review</topic><topic>Smoke - adverse effects</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mowbray, N. G.</creatorcontrib><creatorcontrib>Ansell, J.</creatorcontrib><creatorcontrib>Horwood, J.</creatorcontrib><creatorcontrib>Cornish, J.</creatorcontrib><creatorcontrib>Rizkallah, P.</creatorcontrib><creatorcontrib>Parker, A.</creatorcontrib><creatorcontrib>Wall, P.</creatorcontrib><creatorcontrib>Spinelli, A.</creatorcontrib><creatorcontrib>Torkington, J.</creatorcontrib><collection>Open Access: Wiley-Blackwell Open Access Journals</collection><collection>Wiley-Blackwell Open Access Backfiles</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mowbray, N. G.</au><au>Ansell, J.</au><au>Horwood, J.</au><au>Cornish, J.</au><au>Rizkallah, P.</au><au>Parker, A.</au><au>Wall, P.</au><au>Spinelli, A.</au><au>Torkington, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safe management of surgical smoke in the age of COVID‐19</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2020-10</date><risdate>2020</risdate><volume>107</volume><issue>11</issue><spage>1406</spage><epage>1413</epage><pages>1406-1413</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><abstract>Background
The COVID‐19 global pandemic has resulted in a plethora of guidance and opinion from surgical societies. A controversial area concerns the safety of surgically created smoke and the perceived potential higher risk in laparoscopic surgery.
Methods
The limited published evidence was analysed in combination with expert opinion. A review was undertaken of the novel coronavirus with regards to its hazards within surgical smoke and the procedures that could mitigate the potential risks to healthcare staff.
Results
Using existing knowledge of surgical smoke, a theoretical risk of virus transmission exists. Best practice should consider the operating room set‐up, patient movement and operating theatre equipment when producing a COVID‐19 operating protocol. The choice of energy device can affect the smoke produced, and surgeons should manage the pneumoperitoneum meticulously during laparoscopic surgery. Devices to remove surgical smoke, including extractors, filters and non‐filter devices, are discussed in detail.
Conclusion
There is not enough evidence to quantify the risks of COVID‐19 transmission in surgical smoke. However, steps can be undertaken to manage the potential hazards. The advantages of minimally invasive surgery may not need to be sacrificed in the current crisis.
The COVID‐19 pandemic is unprecedented and raises concerns regarding transmission of the virus within surgical smoke. This review summarizes the current evidence and provides advice for its management.
Bad for your health?</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>32363596</pmid><doi>10.1002/bjs.11679</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9931-0145</orcidid><orcidid>https://orcid.org/0000-0002-1493-1768</orcidid><orcidid>https://orcid.org/0000-0002-9302-1761</orcidid><orcidid>https://orcid.org/0000-0002-3218-0574</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of surgery, 2020-10, Vol.107 (11), p.1406-1413 |
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| source | MEDLINE; Oxford University Press Journals; Wiley Online Library Journals |
| subjects | COVID-19 - prevention & control COVID-19 - transmission Humans Infection Control - instrumentation Infection Control - methods Infectious Disease Transmission, Patient-to-Professional - prevention & control Laparoscopy Laparoscopy - adverse effects Laparoscopy - instrumentation Laparoscopy - methods Minimally invasive surgery Review Smoke - adverse effects Surgery |
| title | Safe management of surgical smoke in the age of COVID‐19 |
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