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Safe management of surgical smoke in the age of COVID-19

Mowbray, N. G., Ansell, J., Horwood, J., Cornish, J., Rizkallah, P., Parker, A., Wall, P., Spinelli, A. and Torkington, J. 2020. Safe management of surgical smoke in the age of COVID-19. British Journal of Surgery 107 (11) , pp. 1406-1413. 10.1002/bjs.11679

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BackgroundThe 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.MethodsThe 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.ResultsUsing 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.ConclusionThere 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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Wiley
ISSN: 0007-1323
Date of First Compliant Deposit: 5 May 2020
Date of Acceptance: 9 April 2020
Last Modified: 17 Sep 2020 10:33

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