Workplace exposure to carbon dioxide during routine laparoscopy - is it safe?

Background: Minimally invasive surgeries have increased dramatically during the last decades. Carbon dioxide (CO ₂) is the gas used for insufflation during laparoscopies, creating space and visibility. The CO ₂ leaks into ambient air through ports where instruments are inserted. If the CO ₂ reaches a certain concentration it affects personnel health. There are national occupational exposure limits (OEL) for CO ₂, including a level limit value (LLV) of 5000 ppm. We are not aware of any previous studies addressing occupational exposure to CO ₂ during laparoscopies. The aim of this study was to assess the compliance to national OELs for CO ₂ during laparoscopies. Methods: A gas detector was placed in the breathing zone of personnel in the operating theatre. The detector measured CO ₂ concentrations every tenth minute during laparoscopies in three locations. Results: During 27 laparoscopies, the measured CO ₂ reached a maximum concentration of 1100 ppm, less than one fourth of the LLV. Median CO ₂ concentration was 700 ppm. Conclusion: Results show that the occupational exposure to CO ₂ during laparoscopies is well below set OELs. Our findings support personnel safety associated with routine use of CO ₂ during laparoscopies.