Background and importance Surgical smoke is composed of chemical substances, viable cells and viral particles (HBV, HPV, HIV) of unproven contagiousness for the operating theatre staff. In the context of the COVID-19 health crisis, several learned societies (SFCO, SCGP, SAGES) recommended the use of systems that filter the surgical plume during an invasive procedure, the presence of this virus in the pneumoperitoneum not being excluded.
Aim and objectives The objective was to perform a comparative study of existing medical devices (MD) on the market with enough filtration capacity to trap SARS-CoV-2.
Material and methods We performed a literature review, contacted providers susceptible to market this type of MD, drew a summary table comparing the different characteristics and costs, and finally, analysed the responses in collaboration with the surgical team, hygiene and the biomedical engineer.
Results We identified two categories of MD. The first can be used in laparotomy: tubing or scalpel connected to a suction terminal or a smoke aspirator. The second are intended for laparoscopy. Some of them provide passive filtration. They are filters connected to the trocar valve. Others perform active filtration. This is done by means of a tube that is connected on one side to the trocar valve. On the other side, it is connected either to the wall vacuum or to a smoke aspirator or a generator with a dual function: insufflation and aspiration. All of these systems use ULPA quality filters with variable porosity and classification depending on the supplier. Finally, there is a generator using electrostatic precipitation. It electrically charges the particles, which then precipitate against the walls of the peritoneal cavity throughout their formation. The price of the consumables varies from 8 to 182€, excluding taxes.
Conclusion and relevance A panel of MDs for surgical smoke filtration was available. To ensure the safety of operating theatre personnel while controlling costs, we established a strategy based on the patient‘s viral status: if the patient was COVID-19 positive, a filtration device with insufflation and aspiration was preferred, while if the patient was only suspected of having COVID-19, passive filtration was preferred to minimise costs. This is subject to change according to the state of scientific knowledge.
Conflict of interest No conflict of interest
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