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

The surgical smoke generated in laparoendoscopic surgery compromises visual clarity and poses health hazards to the operating team. While numerous strategies to maintain a clear surgical field and mitigate these risks have been developed, existing research remains fragmented. This lack of systematic evidence of effective solutions creates challenges in clinical practice.

We conducted this study to evaluate the effectiveness of current smoke evacuation methods aimed at maintaining surgical field visibility and mitigating occupational hazards during laparoendoscopic procedures. The analysis synthesizes literature retrieved from PubMed/MEDLINE, Scopus, and the Cochrane Library databases, with all included studies published up until January, 2025.

A total of 19 techniques were categorized systematically into four distinct approaches: active instrument-tip suction, port-side evacuation, valveless trocar systems, and continuous suction for gasless laparoendoscopy. Each category exhibits unique operational mechanisms, advantages, and limitations.

Multiple solutions exist for surgical smoke management in laparoendoscopic procedures, but their future development should prioritize creating more efficient, user-friendly, and safer evacuation technologies that will account for global healthcare resource disparities to ensure broad clinical applicability.