Login to Access Video or Poster Abstract: MP02-20
Sources of Funding: none

Introduction

Surgical smoke, which is produced during surgical procedures by electronic devices, contains harmful gases. Although these gases are also produced during transurethral resection (TUR), the dangers of surgical smoke in urological procedures are not widely known. The present study analyzed the gas composition of surgical smoke during TUR of the prostate (TURP), and investigated a technique to protect against the effects of harmful gases.

Methods

A total of 54 TURP (in saline) cases were enrolled and divided into two groups according to the irrigation evacuation methods: (1) spontaneous irrigation with outlets opened by natural pressure (open irrigation group) or (2) continuous irrigation with closed suction to outlets by continuous evacuation (closed irrigation group). The clinical parameters were analyzed in both groups. The conditions in the operating room during TURP were evaluated by the surgical staff with face scale questionnaires. The composition of the surgical smoke produced by TURP was collected into charcoal tubes, and analyzed by gas chromatography.

Results

The two groups did not differ in operation time or postoperative hemoglobin values, whereas resection efficiency was better in the closed irrigation group (0.45 gram/min) than in the open irrigation group (0.38 gram/min) (p=0.002). The conditions in the operating room improved significantly by a decrease in the unpleasant smell in the closed irrigation group (3.6, by face scale) compared to that in the open irrigation group (1.1, by face scale) (p<.0001). The closed irrigation system was able to expel the gases remaining in the dome of the bladder during TURP. The surgical smoke produced during TURP contained several gases including benzene and ethylbenzene, which are known carcinogens.

Conclusions

The surgical smoke produced by TURP contained carcinogenic gases. The application of the closed irrigation system during TURP would significantly improve conditions in the operating room and reduce exposure of the staff to the harmful effects of the gases by clearing this occupational hazard

Funding

none