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Clearing the Smoke in the Operating Room

Ethicon sets out to reduce potential risks posed by surgical smoke.

Megadyne Ace Blade 700 soft tissue dissector

Ethicon's Megadyne Ace Blade 700 soft tissue dissector is designed to minimize surgical smoke. Image courtesy of Ethicon.

Las Vegas aside, you’d be hard-pressed to find any employer in the United States that permits smoking in the workplace. The dangers of inhaling cigarette smoke have been well known for decades. But there is a place that harbors something even more hazardous in the air, and it is probably one you would have never expected—your local hospital’s operating room.

This harmful substance is known as surgical smoke, and it is made up of toxic vapors, bioaresols that contain dead and living cell material, blood fragments, and viruses. It is generated by any surgery that uses instruments such as electrocautery and ultrasonic devices, and bone saws and drills.

Surgical smoke has been shown to be even more dangerous than tobacco smoke. This is according to a study in which researchers applied a carbon dioxide laser to one gram of tissue. Then they vaporized an identical gram of tissue with electrosurgical current. The emitted chemical byproducts of both experiments were compared with those found in average tobacco smoke. The results showed that the laser smoke generated from one gram of tissue was equivalent to smoking three unfiltered cigarettes. The electrosurgical smoke was equivalent to smoking six unfiltered cigarettes.

The fumes also contain mutagens, agents that cause genetic mutations. Formaldehyde and acetaldehyde, both probable human carcinogens, are also found in varying levels. These findings have led both the Association of periOperative Registered Nurses and the National Institute for Occupational Safety and Health to recommend that smoke be removed from operating rooms by use of evacuation.

To address this need, Ethicon has developed a line of energy products for reducing surgical smoke. These include the Megadyne smoke evacuation pencils and smoke evacuators. “At Ethicon, we are focused on addressing unmet healthcare needs, and reducing exposure to surgical smoke in the OR is a top priority,” said Andrew Ekdahl, president of Ethicon US, in an interview. “With the addition of Megadyne to our energy portfolio, we are working with hospitals to support their plans to reduce surgical smoke for the benefit of every patient and everyone on the operating room team.”

The company’s latest offering, the Megadyne Ace Blade 700 soft tissue dissector, aims to reduce surgical smoke by creating less of it in the first place. This device is powered by patented Geometric Electron Modulation (GEM) technology, which achieves a scalpel-like cutting effect by creating a low-voltage plasma. This optimizes the voltage for the blade geometry and modulates power based on tissue impedance. Standard monopolar electrosurgery uses constant power, which means the same amount of energy is delivered to the tissue, regardless of impedance. GEM technology focuses energy to the tapered edges of the dissector and delivers the minimum power needed to cut. Because a smaller, more precise, area of tissue is treated with heat, a smaller amount of smoke is created.

The Ace Blade 700 produces 99.6% less surgical smoke than stainless steel monopolar electrosurgery, according to the company. It also provides a 97% reduction in toxic BaP, a known carcinogen, and a 75% reduction in phenanthrene, a known irritant.

The device is used for soft tissue cutting and coagulation. Applications include orthopedic, plastic, and breast oncology surgeries.

Susan Shepard

Susan Shepard

Susan Shepard is a freelance contributor to MD + DI.

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