Quantitative comparison of three electrosurgical smoke evacuation systems

Electrosurgical equipment used during surgery generate smoke consisting of particles, vapor, aerosols and potentially harmful biological agents. Smoke evacuation systems are used more commonly and various types are available. A special image enhancement technique was used to study the behavior of surgical smoke and the effectiveness of smoke evacuation systems. Three different smoke evacuation systems were investigated. Rapid vac (Valleylab Boulder CO) The Buffalo silent whisper turbo (Buffalo, NY) ERBE IES 300 ( Tübingen, Germany) A back scatter illumination technique in combination with a high speed camera was applied to image the dynamics of a smoke plume generated by vaporizing a homogenous meat paste irradiated with the beam of a 10 W cw CO ₂ laser moving at a constant speed. The three different smoke evacuation systems with their individual nozzles, were held 2 cm above the surface of the meat paste and were switched on and off at fixed intervals to mimic a clinical situation. For images analysis, software was developed to count 'smoke pixels' in the video frames as a quantification tool. For the observer's eye, there were no differences between the systems. However, images quantification showed significantly less 'smoke' for the Buffalo system. It is expected that the performance in a clinical situation is also influenced by additional conditions like nozzle design, airflow and noise level. Noise levels were measured at the tip of the nozzle, 80 cm from the tip, 140 cm from the tip. The Buffalo system is the loudest system at every distance measured.