title: Health risk to medical personnel of surgical smoke produced during laparoscopic surgery.
abstract: OBJECTIVE
  During laparoscopic cholecystectomy, the removal of the gall bladder, pyrolysis occurs in the peritoneal cavity. Chemical substances which are formed during this process escape into the operating room through trocars in the form of surgical smoke. The aim of this study was to identify and quantitatively measure a number of selected chemical substances found in surgical smoke and to assess the risk they carry to medical personnel.
  
  
  METHODS
  The study was performed at the Maria Skłodowska-Curie Memorial Provincial Specialist Hospital in Zgierz between 2011 and 2013. Air samples were collected in the operating room during laparoscopic cholecystectomy.
  
  
  RESULTS
  A complete qualitative and quantitative analysis of the air samples showed a number of chemical substances present, such as aldehydes, benzene, toluene, ethylbenzene, xylene, ozone, dioxins and others.
  
  
  CONCLUSIONS
  The concentrations of these substances were much lower than the hygienic standards allowed by the European Union Maximum Acceptable Concentration (MAC). The calculated risk of developing cancer as a result of exposure to surgical smoke during laparoscopic cholecystectomy is negligible. Yet it should be kept in mind that repeated exposure to a cocktail of these substances increases the possibility of developing adverse effects. Many of these compounds are toxic, and may possibly be carcinogenic, mutagenic or genotoxic. Therefore, it is necessary to remove surgical smoke from the operating room in order to protect medical personnel.
authors.affiliation: Medical University of Lodz, Łódź, Poland (Department of General and Oncological Surgery). miloszd@onet.pl.
authors.forename: Miłosz
authors.initials: M
authors.lastname: Dobrogowski
authors.affiliation: Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Chemical Hazard). wwesolow@imp.lodz.pl.
authors.forename: Wiktor
authors.initials: W
authors.lastname: Wesolowski
authors.affiliation: Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Chemical Hazard). mkuch@imp.lodz.pl.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Kucharska
authors.affiliation: Medical University of Lodz, Łódź, Poland (Department of General and Oncological Surgery).
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Paduszyńska
authors.affiliation: Medical University of Lodz, Łódź, Poland (Department of General and Oncological Surgery). agacelnik@gmail.com.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Dworzyńska
authors.affiliation: University of Lodz, Łódź, Poland (Institute of Psychology). wiesiek_szym@yahoo.co.uk.
authors.forename: Wiesław
authors.initials: W
authors.lastname: Szymczak
authors.affiliation: Medical University of Lodz, Łódź, Poland (Department of Toxicology and Bromatology). andrzej.sapota@umed.lodz.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Sapota
authors.affiliation: Medical University of Lodz, Łódź, Poland (Department of General and Oncological Surgery). pomorskil@op.pl.
authors.forename: Lech
authors.initials: L
authors.lastname: Pomorski
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects* / Q000032:analysis; D004564:Electrocoagulation / Q000009:adverse effects*; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology*; D009873:Operating Rooms; D011044:Poland / Q000453:epidemiology; D012906:Smoke / Q000009:adverse effects* / Q000032:analysis
chemical_list: D000395:Air Pollutants, Occupational; D012906:Smoke
keywords: dioxins; exposure; health risk; laparoscopic cholecystectomy; pyrolysis; smoke; volatile organic compounds