Development of a closed‑circuit transurethral resection system for effective capture of harmful surgical smoke

Exposure to harmful gases in the operating room (OR) is an occupational risk for health care personnel; however, it remains insufficiently recognized during transurethral resection (TUR) procedures. This study aimed to develop a simple closed -circuit TUR system to prevent exposure to surgical smoke, and evaluate its effectiveness. The system was constructed by connecting a suction tube to a drainage port to contain gases generated during TUR of the prostate (TURP). The collected gases were analyzed using gas chromatography to identify potentially toxic substances. The effect of odor control was assessed by 14 OR staff members during 2 TURP procedures (2 performed with the closed-circuit system, and 2 with the conventional system) using a 6 -point Likert scale. The closed -circuit technique was safely and effectively applied during clinical TURP procedures, successfully capturing surgical smoke containing carcinogenic compounds, such as benzene and ethylbenzene. Median (interquartile range) odor score during TURP was lower with the closed -circuit than conventional system (1 [1-1] vs 4; [3-4]; P <0.01). These results indicate that the closed -circuit TUR system is a practical and effective method for reducing occupational exposure to surgical smoke during TURP.