Risk of contamination from laparoscopic carbon dioxide insufflators

Ten high flow laparoscopic carbon dioxides insufflators were examined to determine whether there was significant particulate or bacterial contamination of the gas delivered to patients. The gas delivery tubing and connections in the insufflators were also examined for the presence of bacterial colonization and for evidence of retrograde passage of body fluids to the insufflator. Metallic particulate debris was recovered from gas from all 10 insufflators. Staphylococci were recovered from the insufflated gas from one insufflator and from the internal tubing of three insufflators. Swabs from the internal tubing of two insufflators showed evidence of contamination by blood. The metallic particulate contamination of the insufflated gas may not be of clinical significance but the presence of bacteria and blood is a concern. Simple measures to minimize the risk of retrograde flow of gas and fluid to the insufflator should be followed and the provision of a filter between the patient and the insufflator is recommended.