Contamination resulting from aerosolized fluid during laparoscopic surgery.

Area of Science:

• Surgical Safety
• Minimally Invasive Surgery
• Biomedical Engineering

Background:

• Laparoscopic surgery involves creating intra-abdominal pressure (pneumoperitoneum).
• Releasing this pressure can aerosolize blood droplets, posing an environmental hazard.
• The extent of blood spatter during pneumoperitoneum release is not well quantified.

Purpose of the Study:

• To describe and measure aerosolized blood contamination during pneumoperitoneum evacuation in laparoscopic surgery.
• To quantify the amount, size, and distribution of blood spatter.
• To assess the need for enhanced protective measures for surgical teams.

Main Methods:

• Trocar removal from the abdomen under 15 mm Hg pneumoperitoneum.
• Collection of blood spatter on poster boards placed above the incision.
• Analysis using machine vision, luminol fluorescence, and computerized spatial analysis.

Main Results:

• Blood spatter was detected on all 27 analyzed boards.
• Luminol enhanced the visualization of blood spatter.
• Most spatter was a fine mist, with individual droplets ranging from 0.53×10(-3) to 7.11×10(-3) sq in.

Conclusions:

• Pneumoperitoneum evacuation consistently leads to aerosolized blood contamination.
• The majority of blood spatter is not visible to the naked eye.
• Surgical teams require appropriate protective barriers and environmental controls during pneumoperitoneal evacuation.