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


CONCLUSIONS
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.
Hübner
Martin
M
Department of Visceral and Transplantation Surgery, University Hospital Zürich, Switzerland. dieter.hahnloser@usz.ch.
Sigrist
Markus W
MW
Demartines
Nicolas
N
Gianella
Michele
M
Clavien
Pierre A
PA
Hahnloser
Dieter
D