Particulate matter produced by energy-based surgical instruments rapidly accumulates and obscures the visual field making difficult and complex tasks even harder. This “surgical smoke” must be dealt with. Clearing the surgical smoke by releasing it into the operating room is inefficient, delays the operation and causes loss of pneumoperitoneum. Chronic exposure to surgical smoke may be hazardous to operating room personnel.
Using a surgical smoke evacuator can accelerate this process and minimise staff exposure but it results in a dramatic increase in patient exposure to carbon dioxide (CO2). This increases the risk of post-surgical adhesion formation, increases the risk of post-surgical pain, cools the patient and complicates anaesthetic control. For these reasons, smoke evacuators remain poorly adopted in laparoscopic surgery.