Methods used for smoke evacuation in laparoendoscopic surgery: a technical review.

Area of Science:

• Minimally Invasive Surgery
• Occupational Health and Safety

Background:

• Surgical smoke from laparoendoscopic procedures impairs visibility and presents health risks to surgical teams.
• Existing research on managing surgical smoke is fragmented, hindering clinical practice.
• A systematic review is needed to evaluate effective smoke evacuation strategies.

Purpose of the Study:

• To evaluate the effectiveness of current surgical smoke evacuation methods in laparoendoscopic surgery.
• To assess strategies for maintaining surgical field clarity and mitigating occupational hazards.
• To synthesize evidence on solutions for laparoendoscopic surgical smoke.

Main Methods:

• Systematic literature review of PubMed/MEDLINE, Scopus, and Cochrane Library databases.
• Inclusion of studies published up to January 2025.
• Categorization of identified smoke evacuation techniques.

Main Results:

• Nineteen distinct surgical smoke evacuation techniques were identified and systematically categorized.
• Techniques were grouped into four main approaches: active instrument-tip suction, port-side evacuation, valveless trocar systems, and continuous suction for gasless laparoendoscopy.
• Each category presents unique operational mechanisms, advantages, and limitations.

Conclusions:

• Multiple solutions exist for managing surgical smoke in laparoendoscopic procedures.
• Future technologies should focus on efficiency, user-friendliness, and safety.
• Development must consider global healthcare resource disparities for broad clinical applicability.