Contamination resulting from aerosolized fluid during laparoscopic surgery.
OBJECTIVE
Aerosolized droplets of blood can travel considerable distances on release of intra-abdominal pressure during laparoscopic surgery. This creates an environmental hazard for members of the surgical team. This study describes and provides a method of measurement of aerosolized blood contamination during evacuation of the pneumoperitoneum in laparoscopic surgery.


METHODS
Samples were measured by removing a trocar from the abdomen while a pneumoperitoneum of 15 mm Hg was present. A white poster board was placed 24 inches above the incision to catch the released blood spatter. By use of machine vision, luminol fluorescence, and computerized spatial analysis, data from the boards were recorded, analyzed, and scored based on the distance, size, and quantity of particulate contamination.


RESULTS
We analyzed 27 boards. Spatter was present on every board. The addition of luminol to the boards increased the amount of visible spatter. Most tests created <1000 blood spatters. Fluids are typically ejected as a fine mist. Every test included at least 1 blood spatter. The range of the average blood spatter size was 0.53×10(-3) to 7.11×10(-3) sq in. The amount of spatter detected did not show any apparent correlation with the patient's body mass index, the estimated blood loss, or the type of operation performed.


CONCLUSIONS
Evacuation of the pneumoperitoneum during laparoscopic surgery results in consistent contamination. Most blood spatter is not visible to the naked eye. Our results suggest that all surgical participants should wear appropriate protective barriers and conscious measures should be undertaken to prevent environmental contamination during pneumoperitoneal evacuation.
Bariatric Medical Institute of Texas, San Antonio, TX, USA.
Richard K
RK
Englehardt
Department of Mechanical Engineering, University of Texas at San Antonio, San Antonio, TX, USA.
Brent M
BM
Nowak
Bariatric Medical Institute of Texas, San Antonio, TX, USA.
Michael V
MV
Seger
Bariatric Medical Institute of Texas, San Antonio, TX, USA.
Frank D
FD
Duperier
D000336:Aerosols / Q000009:adverse effects*; D004866:Equipment Contamination; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D020706:Laparoscopes / Q000009:adverse effects*; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D011027:Pneumoperitoneum / Q000139:chemically induced*
D000336:Aerosols
aerosolized blood; blood spatter; laparoscopy safety