| When surgeons use the electrocautery during surgery, they inadvertently create a potentially harmful plume of smoke. This smoke can be a respiratory irritant to the surgical team and to the patient, but more importantly, it can be a source of airborne infection. There is a risk that the smoke generated by these procedures is carcinogenic, mutagenic, or otherwise infectious. To minimize the risk of infectious particulates, it is recommended that a smoke evacuator be used. Smoke evacuators are filtered suction devices that suction the smoke away from the surgical site. Typically, these filters are comprised of a high-efficiency particulate removing filter and odor reducing media. Smoke evacuators should have an Ultra Low Penetrating Air(ULPA) efficiency rating of better than 99.99 percent at 0.2 to 0.3 microns and should maintain this rating below 0.1 microns.
The following are a sample of surgical smoke evacuators on the market today:
- The SAFE® System Surgical Smoke Evacuation System from Edge Systems Corporation.
- The VitalVac® Surgical Smoke Evacuator and the AirSafe® Versavac2 Surgical Smoke Evacuator from Stackhouse.
- The Plume-Inator® and the Surgifresh® Mini from Surgimedics.
- The SmartVac Smoke Evacuation System from Niche Medical Inc.
The SAFE System Surgical Smoke Evacuation System from Edge Systems Corporation is 9x 9” and 14” high. It weighs 25 lbs and is quieter than many other smoke evacuation systems at 52 dBA. The SAFE system boasts a ULPA efficiency rating of 99.999+ percent at 0.12 micron.
Both the VitaVac Surgical Smoke Evacuator and the AirSafe VersaVac2 Surgical Smoke Evacuator from Stackhouse are quiet, compact, and economical. The VitaVac is a basic system that can be used in various modes such as manual, footswitch remote, and laparoscopy. The AirSafe VersaVac2 contains a new FreshAire ULPA filter, which captures the total plume, provides effective odor control and has a 12-hour filter life. The FreshAire filter uses a three stage filter: prefilter, activated carbon for odor absorption, and ULPA filtration with the efficiency of 99.9997 percent at 0.12 microns. The AirSafe VersaVac2 remove smoke from laser and ESU devices, and is also suitable to use in the doctor’s office. Stackhouse offers a variety of accessories, such as tubing and wands, to be used with the AirSafe VersaVac2 and the VitaVac.
Surgimedics offers the Plume-Inator and Surgifresh Mini. The Plume-Inator is the strongest vacuum in Surgimedic’s line of smoke evacuators. Its dimensions are 28” x 14” and it is 28” high. The Plume-Inator weighs 41 lbs. It is available in a 100-120 VAC and a 220-240 VAC, both at 50/60 HZ. The Surgifresh Mini matches the Plume-Inator in ruggedness, but is the ideal size for an operating room, clinic, or office setting. It is 8 7/8” x 9 1/8” and 22” high, and weighs 21 lbs.
The SmartVac Smoke Evacuation System from Niche Medical Inc enables the surgeon to control the vacuum flow by providing ten different air flow settings. Each setting gradually pulls more cubic feet per minute of air through the filter port. Due to a strong motor, low settings are often sufficient for many ESU and laser applications. In addition, the SmartVac notifies the user when to change the filter by gauging the actual amount of particulate in the filter. Also, it includes an invaginated tissue release feature that automatically vents vacuum when an occlusion or tissue invagination is detected, thereby minimizing tissue trauma. The SmokeTrap™ First Filter lasts an average of twenty procedures and holds up to 100 cc of fluid to avoid the need to interrupt the procedure to protect the filter and evacuator from premature failure. The filter also includes charcoal that reduces smoke odor and is easy to change, requiring no biomedical department assistance. The SmartVac is ultra quiet and adapts to both open an laparoscopic procedures. During open ESU procedures, the SmartVac can be used in conjunction with the Niche Medical’s VacuPen™ Plume Collector, which adapts to almost any ESU pencil to efficiently collect smoke at the point of generation.
Studies have shown that the use of surgical smoke evacuators at the surgical site can reduce the presence of surgical plume in the operating room. Listed above are several options that provide acceptable ULPA efficiency, vacuum power, mobility, and compactness. With so many viable options, eliminating surgical plume is as easy as selecting the device that best fits your needs.
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