UHWI team finds solution for surgical smoke

CONSULTANT plastic surgeon at the University Hospital of the West Indies (UHWI) Dr Rajiv Vengopaul and a team from the Department of Surgery have come up with an affordable solution to tackle surgical smoke in operating theatres.

The solution is expected to be a helpful tool in ensuring the health and wellness of theatre personnel, as the team, having established that surgical smoke affects all members in the operating theatre, also recognises that commercially designed smoke extractors are not readily available in Third World countries due to the cost.

In an interview with Jamaica Information Service (JIS) News, Dr Vengopaul explained that the need to find a solution became necessary, as the environment created in the operating theatre by necessary work tools was affecting his health.

He said that he and his team undertook research on how to eliminate surgical smoke, explaining that it was important, as the study dealt with occupational health.

It featured the process of treating with smoke that is related to the use of an electrocautery machine, which is commonly used in surgery.

“The device is used to achieve haemostasis, which means trying to stop bleeding within the surgical field. It actually works with electric current. Depending on the cycle of the current, you can cut tissue as well as stop bleeding,” Dr Vengopaul explained.

“This has been a significant breakthrough in the surgical field since the early 1900s, because it allows us to do surgery more efficiently, more quickly and with minimum blood loss during the procedure,” he said.

However, he pointed out that one of the main side effects of electrocauterisation is the creation of a surgical smoke plume, which contains many toxic agents similar to those produced in cigarette smoke.

“The literature suggests that one month of being exposed to surgical smoke would be equivalent to smoking about 30 cigarettes,” he added.

According to Dr Vengopaul, the team created a very affordable method of removing the surgical plume.

“We used a nasogastric tube, which is plastic; removed the cuffs from rubber gloves and attached it to the pencil, which is the tool through which the electro-current is used to do the tissue work. This is attached to the general suction unit which is used in all operating theatres, so that as the smoke is created from the tip of the pencil, it is moved out,” he explained.

Dr Vengopaul said the solution, which has been dubbed the Smoke and Fluid Evacuation (SAFE) tube “is a simple, economical and reproducible alternative”.

He pointed out that in a survey that was conducted among 99 members of staff, everyone had an issue with surgical smoke. There was 84 per cent satisfaction in the ability of the device to remove smoke and fluid from the operative field by users, and 91 per cent of participants indicated that they would use the device in future surgeries.

The team has concluded that the SAFE tube represents a simple, economical and green solution to the problem.