Hazardous Surgical Smoke: Risk Assessment and Evaluation of a New Smoke Extractor System in the Surgical Unit

Study Overview
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Brief Summary
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The investigators will define two separate groups of surgical procedures: 1.) an 'open group' in which mainly open anatomic lung resections will be included, and 2.) a 'minimally invasive' group in which mainly thoracoscopic anatomic lung resections will be included. Both groups will then be randomized to either the performance of the surgical procedure under 'standard conditions' or to the performance of the procedure with the additional use of a smoke evacuation system. During every procedure the hazardous smoke that is generated by the electrocautery in the surgical field will be collected through a tube at the height of the surgeons face. The smoke is then directly transferred to a mass spectrometer that is situated in the operating room (OR) and performs a real-time analysis of the chemical substances in the air. The degree of air pollution will be measured as well as the smoke evacuation systems' ability to reduce these hazardous chemical substances in the air can be evaluated.

Detailed Description
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Smoke samples will be continuously analyzed with a latest generation time of flight mass spectrometer in real time. Concerning the smoke evacuation device, the investigators will use the model IES 2 (Intelligent Evacuation System) from Erbe Swiss medical for this study. Since this is only an observational study in which the investigators are only recording the type of surgery (i.e. open oder minimally invasive) and not recording sensitive patient data, the local ethics committee waived the need for an ethics committee approval of the study. In the end the smoke evacuation system does not have an effect on the patient or the procedure itself, but may rather influence the concentration of hazardous surgical fumes in the operating theatre.

Official Title
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Hazardous Surgical Smoke: Risk Assessment and Evaluation of a New Smoke Extractor System (SES) in the Surgical Unit

Conditions
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Lung Cancer, Lung Injury

Intervention / Treatment
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* Device: Smoke evacuation system


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - All surgical procedures with a planned duration of more than 1 hour Exclusion Criteria: Patients with a contraindication for electrocautery use Patients with Pacemaker or implantable cardioverter-defibrillator (ICD) Patients with an implanted neurostimulator device

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Minimally invasive surgery with smoke evacuation system (SES)<br>minimally invasive surgical procedures during which a smoke evacuation device is used | Device: Smoke evacuation system<br>* The smoke evacuation system removes the surgical smoke directly near the electrocautery tip, where it is generated<br>|
| Minimally invasive surgery without SES<br>minimally invasive surgical procedures during which no smoke evacuation device is used | |
| Open surgery with SES<br>open surgical procedures during which a smoke evacuation device is used | Device: Smoke evacuation system<br>* The smoke evacuation system removes the surgical smoke directly near the electrocautery tip, where it is generated<br>|
| Open surgery without SES<br>open surgical procedures during which no smoke evacuation device is used | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hazardous fumes - specifically the concentration of Furfural, Benzene and Butadiene | Analysis of surgical fume with real-time time of flight mass spectrometry | assessment of measurement will start 4 months after the project is started and will take up to 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Smoke, Plume, Electrocautery, Mass spectrometer