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Experimental Model to Test Electrostatic Precipitation Technology in the COVID-19 Era: A Pilot Study - 23/11/20

Doi : 10.1016/j.jamcollsurg.2020.08.759 
Jonathan R. Buggisch a, , Daniel Göhler, Dipl Ing e, Alain Le Pape, PhD, PharmD, DSc a, Sébastien Roger, PhD b, c, Mehdi Ouaissi, MD, PhD b, d, Michael Stintz, Dr Ing habil f, Andreas Rudolph, Dr Ing e, Urs Giger-Pabst, MD g
a CNRS UPS44, CIPA, PHENOMIN-TAAM, Orléans, Tours, France 
b EA4245 Transplantation, Immunologie, Inflammation, Université de Tours, Tours, Tours, France 
c Institut Universitaire de France, Paris, Tours, France 
d Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, University Hospital of Tours, Tours, France 
e Technologie-orientierte Partikel-, Analysen- und Sensortechnik, Topas GmbH, Dresden, Germany 
f Research Group Mechanical Process Engineering, Institute of Process Engineering and Environmental Technology, Technische Universität Dresden, Dresden, Germany 
g Chirurgische Klinik I, Mathias-Spital Rheine, Germany 

Correspondence address: Jonathan R Buggisch, University of Münster, Albert-Schweitzer-Straße 21, 48149 Münster, Germany.University of MünsterAlbert-Schweitzer-Straße 21Münster48149Germany

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Abstract

Background

In the COVID-19 crisis, laparoscopic surgery is in focus as a relevant source of bioaerosol release. The efficacy of electrostatic aerosol precipitation (EAP) and continuous aerosol evacuation (CAE) to eliminate bioaerosols during laparoscopic surgery was verified.

Study design

Ex-vivo laparoscopic cholecystectomies (LCs) were simulated ± EAP or CAE in Pelvitrainer equipped with swine gallbladders. Release of bioaerosols was initiated by performing high-frequency electrosurgery with a monopolar electro hook (MP-HOOK) force at 40 watts (MP-HOOK40) and 60 watts (MP-HOOK60), as well as by ultrasonic cutting (USC). Particle number concentrations (PNC) of arising aerosols were analyzed with a condensation particle counter (CPC). Aerosol samples were taken within the Pelvitrainer close to the source, outside the Pelvitrainer at the working trocar, and in the breathing zone of the surgeon.

Results

Within the Pelvitrainer, MP-HOOK40 (6.4 × 105 cm-3) and MP-HOOK60 (7.3 × 105 cm-3) showed significantly higher median PNCs compared to USC (4.4 × 105 cm-3) (p = 0.001). EAP led to a significant decrease of the median PNCs in all 3 groups. A high linear correlation with Pearson correlation coefficients of 0.852, 0.825, and 0.759 were observed by comparing MP-HOOK40 (± EAP), MP-HOOK60 (± EAP), and USC (± EAP), respectively. During ex-vivo LC and CAE, significant bioaerosol contaminations of the operating room occurred. Ex-vivo LC with EAP led to a considerable reduction of the bioaerosol concentration.

Conclusions

EAP was found to be efficient for intraoperative bioaerosol elimination and reducing the risk of bioaerosol exposure for surgical staff.

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Abbreviations and Acronyms : CAE, COVID-19, CPC, EAP, LC, MP HOOK, PNC, USC


Esquema


 Authors Buggisch and Göhler contributed equally to this work.
 Disclosure Information: Nothing to disclose.
 Support: Dr Göhler was supported by the Development Bank of Saxony (SAB) under grant 100374636.
 Disclaimer: We explicitly emphasize that all authors declare no financial ties or any other conflicts of interest with Aesculap, BOWA-electronic or Alesi Surgical. Furthermore, there is no conflict of interest or financial ties to declare between Alesi Surgical and Aesculap.


© 2020  American College of Surgeons. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 231 - N° 6

P. 704-712 - décembre 2020 Regresar al número
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