Editor
The global pandemic produced by SARS-CoV-2 started in the Chinese province of Wuhan in December 2019.1 It has caused more than four million cases and almost 320.000 deaths. In Spain there are more than 230.000 people infected by the virus and 27.700 deaths have been reported, with an estimate of around 20% of the cases affecting health care professionals according to the reports of the European Center for Disease Prevention and Control2.
There is enough evidence on the elevated propagation of this microorganism during procedures that generate aerosols, because of wich the control of this situation on the operating room is mandatory3,4. This risk does not only take place during the anesthetic process; laparoscopic surgery is one of procedures that generates aerosols5, in an even higher concentration than the observed during open surgery6. For this reason, the scientific associations recommend to be careful and the use of devices that filter surgical fumes to minimize the possibility of dissemination of particles generated during the surgery7–10.
Although there are different fume evacuation systems to use during laparoscopy on the market8, these are not always available in every center due to different reasons.
A closed system has been designed for the extraction of surgical fumes, by adapting a generic passive heat and moisture exchange (HME) filter.
The system that we present, (Figure 1) consists in an HME type filter connected with two adapters in L shape and two connectors to the operating room vacuum device with two hollow silicone tubes. This way, the aerosol aspiration is carried out directly from the laparoscopic port by opening the key. In the other ports we place a lid to prevent an accidental opening during the surgery.
Figure. 1.
The complete system
There is currently about the possibility of infection during surgery due to exposure to surgical fumes, although harmful effects have been known for years5. The lack of this specific evacuation systems during laparoscopy in some centers and the need to perform an urgent surgery or simply maintain surgical activity, the developed system based on HME filters offers an accessible and economical alternative8,10. This type of filters has demonstrated a pathogen filter capacity close to 100%11.
The designed system has been adopted in routine surgical in our hospital since the beginning of the pandemic, along with the rest protection measures12 with great adaptation and satisfaction of the entire surgical team.
The fume evacuation system based on an adapted HME filter is an easily accessible and economical alternative that should be implanted in all laparoscopic procedures in case of not having any specific fume evacuation systems.
Disclosure
The authors declare no conflict of interest.
Contributor Information
Pau Sarrió-Sanz, Email: pausarrio@gmail.com.
Luis Gómez-Pérez, Email: luisgope@gmail.com.
References
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