Surgical Smoke Toxic Byproducts Could Harm Surgeons

Surgical smoke, a common byproduct of procedures such as combined transurethral resection and vaporization of the prostate (CTURVP), contains toxic chemicals, including some explosive and harmful carcinogens, according to a new study.

Researchers from Chonbuk National University (Jeonbuk, Korea) and Wonkwang University (Iksan City, Korea) analyzed smoke samples from six CTURVP procedures. A total of 12 smoke samples were collected from a continuous irrigation suction drainage system during surgery. The gases were quantitatively and qualitatively analyzed by a gas chromatography-mass spectrometry (GC-MS) system equipped with a purge and trap sample injector.


The researchers found that the main chemical constituents of surgical smokes produced in CTURVP are propylene, allene, isobutylene, 1,3-butadiene, vinylacetylene, mecaptomethane, ethylacetylene, diacetylene, 1-pentene, EtOH, piperylene, propenylacetylene,1,4-pentadiene, cyclopentadiene, acrylnitrile and butyrolacton. All of the chemical are considered toxic, and three of them are carcinogenic. Several of the chemicals can cause central nervous system depression and skin, eye, and respiratory irritation. The study was presented as a poster session at the European Association of Urology (EAU) annual meeting, held during April 2010 in Barcelona (Spain).

"Higher quality filter masks, smoke evacuation device, and/or smoke filter should be developed for safety for operating personnel and patients in CTURVP,” concluded lead author Yun Jo Chung, Ph. D., and colleagues.

"This is certainly an occupational hazard that urologists and operating room personnel working with urologists may be exposed to more often than they would like. Ascertaining the degree to which this exposure may contribute to any ill effects in those people who are exposed will require further study,” commented Anthony Smith, M.D., a spokesperson for the American urological Association (AUA).

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Chonbuk National University
Wonkwang University