Ergonomic problems in surgical smoke control during surgery

Surgical smoke is the plume and air contaminants produced by energy devices such as electrocautery and laser scalpels during the surgery. Surgical smoke consists of fine particles containing pathogenic microorganisms and chemical substances from high-temperature carbonized tissues, and poses a health risk to medical personnel during the surgery. The COVID-19 pandemic has highlighted the importance of surgical smoke control. As a surgical smoke protection on the medical staff side, personal protective equipment such as N-95 high-performance masks are widely used. On the other hand, the surgical smoke exhaust system includes ventilation equipment for the entire operating room and a device that directly aspirates surgical smoke in the operative field. Wearing a mask for a long time poses problems such as fatigue, hypercapnia and loss of concentration. Increasing the smoke evacuation efficiency of a surgical instrument-mounted smoke evacuation device poses problems such as deterioration of operability and patient temperature maintenance. Surgical instruments equipped with smoke suction tubes suffer from deterioration in operability due to increased size and weight. Increased ventilation in the surgical environment may cause drying of organs and hypothermia. Surgical instruments with smoke exhaust devices require further reduction in weight, diameter, and ergonomic design.　 In addition, it is necessary to equip surgical instruments and the ventilation function of the operating room with an automatic maintenance function of body temperature and body cavity temperature and humidity.It is important to enlighten medical workers about the importance of measures against surgical smoke, and to improve the smoke exhaust system considering maintenance of physiological environment and solve ergonomic problems.