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Gas emission during laparoscopic colorectal surgery using a bipolar vessel sealing device: A pilot study on four patients.

Hübner M, Sigrist MW, Demartines N, Gianella M, Clavien PA, Hahnloser D - Patient Saf Surg (2008)

Bottom Line: The detected spectra were compared to the available spectra of known toxins.The use of a vessel sealing device during laparoscopic surgery does not produce known toxic substances in relevant quantity.Further studies are needed to identify unknown molecules and to analyze gas emission under various conditions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Visceral and Transplantation Surgery, University Hospital Zürich, Switzerland. dieter.hahnloser@usz.ch.

ABSTRACT

Background: Dissection during laparoscopic surgery produces smoke containing potentially toxic substances. The aim of the present study was to analyze smoke samples produced during laparoscopic colon surgery using a bipolar vessel sealing device (LigaSuretrade mark).

Methods: Four consecutive patients undergoing left-sided colectomy were enrolled in this pilot study. Smoke was produced by the use of LigaSuretrade mark. Samples (5,5l) were evacuated from the pneumoperitoneum in a closed system into a reservoir. Analysis was performed with CO2-laser-based photoacoustic spectroscopy and confirmed by a Fourier-transform infrared spectrum. The detected spectra were compared to the available spectra of known toxins.

Results: Samples from four laparoscopic sigmoid resections were analyzed. No relevant differences were noted regarding patient and operation characteristics. The gas samples were stable over time proven by congruent control measurements as late as 24 h after sampling. The absorption spectra differed considerably between the patients. One broad absorption line at 100 ppm indicating H2O and several unknown molecules were detected. With a sensitivity of alpha min ca 10-5 cm-1 no known toxic substances like phenol or indole were identified.

Conclusion: The use of a vessel sealing device during laparoscopic surgery does not produce known toxic substances in relevant quantity. Further studies are needed to identify unknown molecules and to analyze gas emission under various conditions.

No MeSH data available.


Related in: MedlinePlus

Photoacoustic absorption spectra of two different patients. The displayed photoacoustic absorption spectra originate from operations on two different patients (1 and 2). Striking differences were found in the absorption spectra between wavelengths of 890 to 905 cm-1.
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Figure 3: Photoacoustic absorption spectra of two different patients. The displayed photoacoustic absorption spectra originate from operations on two different patients (1 and 2). Striking differences were found in the absorption spectra between wavelengths of 890 to 905 cm-1.

Mentions: Fig 3 displays the measurements of 26th of January and 2nd of February. Interestingly, different spectra were detected between the two patients. The photoacoustic spectrometer detected besides a dominating CO2 absorption one broad absorption band which was confirmed by FTIR spectral analysis. Apart from 100 ppm H2O vapour several other substances were indicated by their respective absorption spectra (Fig 3). Comparing them to the absorption spectra of 32 substances found in previous studies [5,6], neither toxic substances like phenol or indole nor other known substances could unequivocally be identified. The substances therefore are unknown.


Gas emission during laparoscopic colorectal surgery using a bipolar vessel sealing device: A pilot study on four patients.

Hübner M, Sigrist MW, Demartines N, Gianella M, Clavien PA, Hahnloser D - Patient Saf Surg (2008)

Photoacoustic absorption spectra of two different patients. The displayed photoacoustic absorption spectra originate from operations on two different patients (1 and 2). Striking differences were found in the absorption spectra between wavelengths of 890 to 905 cm-1.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2567292&req=5

Figure 3: Photoacoustic absorption spectra of two different patients. The displayed photoacoustic absorption spectra originate from operations on two different patients (1 and 2). Striking differences were found in the absorption spectra between wavelengths of 890 to 905 cm-1.
Mentions: Fig 3 displays the measurements of 26th of January and 2nd of February. Interestingly, different spectra were detected between the two patients. The photoacoustic spectrometer detected besides a dominating CO2 absorption one broad absorption band which was confirmed by FTIR spectral analysis. Apart from 100 ppm H2O vapour several other substances were indicated by their respective absorption spectra (Fig 3). Comparing them to the absorption spectra of 32 substances found in previous studies [5,6], neither toxic substances like phenol or indole nor other known substances could unequivocally be identified. The substances therefore are unknown.

Bottom Line: The detected spectra were compared to the available spectra of known toxins.The use of a vessel sealing device during laparoscopic surgery does not produce known toxic substances in relevant quantity.Further studies are needed to identify unknown molecules and to analyze gas emission under various conditions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Visceral and Transplantation Surgery, University Hospital Zürich, Switzerland. dieter.hahnloser@usz.ch.

ABSTRACT

Background: Dissection during laparoscopic surgery produces smoke containing potentially toxic substances. The aim of the present study was to analyze smoke samples produced during laparoscopic colon surgery using a bipolar vessel sealing device (LigaSuretrade mark).

Methods: Four consecutive patients undergoing left-sided colectomy were enrolled in this pilot study. Smoke was produced by the use of LigaSuretrade mark. Samples (5,5l) were evacuated from the pneumoperitoneum in a closed system into a reservoir. Analysis was performed with CO2-laser-based photoacoustic spectroscopy and confirmed by a Fourier-transform infrared spectrum. The detected spectra were compared to the available spectra of known toxins.

Results: Samples from four laparoscopic sigmoid resections were analyzed. No relevant differences were noted regarding patient and operation characteristics. The gas samples were stable over time proven by congruent control measurements as late as 24 h after sampling. The absorption spectra differed considerably between the patients. One broad absorption line at 100 ppm indicating H2O and several unknown molecules were detected. With a sensitivity of alpha min ca 10-5 cm-1 no known toxic substances like phenol or indole were identified.

Conclusion: The use of a vessel sealing device during laparoscopic surgery does not produce known toxic substances in relevant quantity. Further studies are needed to identify unknown molecules and to analyze gas emission under various conditions.

No MeSH data available.


Related in: MedlinePlus