Geier et al: The effect of a smoke‐evacuation unit on ultrafine particle concentrations in the operating room during approach to the proximal tibia for tibial plateau-leveling osteotomy surgery in dogs
Veterinary Surgery 5, 2022

🔍 Key Findings

Use of smoke evacuators reduced ultrafine particle concentrations by 56.4% during approach to the proximal tibia for TPLO in dogs.
Mean intraoperative particle concentrations were significantly higher in surgeries without smoke evacuation (1352 ppc vs. 763 ppc, P < .0001).
Maximum particle concentrations were six times higher without smoke evacuation (62,450 ppc vs. 10,100 ppc, P < .0001).
Particle counts increased above baseline regardless of evacuator use, confirming electrosurgery contributes substantially to airborne particles.
Surgeons noted reduced odor and health concerns when using the smoke evacuator, despite initial visibility limitations due to pencil attachment.
Standard surgical masks do not protect against ultrafine particles, underscoring the importance of smoke mitigation systems.
The smoke-evacuation unit did not eliminate all ultrafine particles, suggesting optimization (e.g., higher power setting) may be beneficial.
This is the first clinical veterinary study to measure surgical smoke reduction using evacuators during TPLO.

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Geier et al: The effect of a smoke‐evacuation unit on ultrafine particle concentrations in the operating room during approach to the proximal tibia for tibial plateau-leveling osteotomy surgery in dogs
Veterinary Surgery 5, 2022

🔍 Key Findings

Use of smoke evacuators reduced ultrafine particle concentrations by 56.4% during approach to the proximal tibia for TPLO in dogs.
Mean intraoperative particle concentrations were significantly higher in surgeries without smoke evacuation (1352 ppc vs. 763 ppc, P < .0001).
Maximum particle concentrations were six times higher without smoke evacuation (62,450 ppc vs. 10,100 ppc, P < .0001).
Particle counts increased above baseline regardless of evacuator use, confirming electrosurgery contributes substantially to airborne particles.
Surgeons noted reduced odor and health concerns when using the smoke evacuator, despite initial visibility limitations due to pencil attachment.
Standard surgical masks do not protect against ultrafine particles, underscoring the importance of smoke mitigation systems.
The smoke-evacuation unit did not eliminate all ultrafine particles, suggesting optimization (e.g., higher power setting) may be beneficial.
This is the first clinical veterinary study to measure surgical smoke reduction using evacuators during TPLO.

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Multiple Choice Questions on this study

In Geier 2022 et al., on smoke evacuation in TPLO, what was the average reduction in ultrafine particle concentration with the use of a smoke-evacuation unit?

A. 22.8%

B. 35.6%

C. 56.4%

D. 74.1%

E. 90.5%

Answer: 56.4%

Explanation: Smoke-evacuation units reduced particle concentration by 56.4% during approach to the proximal tibia.

In Geier 2022 et al., on smoke evacuation in TPLO, which group had the highest maximum particle concentration during surgery?

A. SE group (10,100 ppc)

B. NSE group (62,450 ppc)

C. Both groups had the same maximum

D. NSE group (10,100 ppc)

E. SE group (62,450 ppc)

Answer: NSE group (62,450 ppc)

Explanation: Maximum particle concentration in the non–smoke-evacuator group was 62,450 ppc vs. 10,100 in the SE group.

In Geier 2022 et al., on smoke evacuation in TPLO, which limitation of the smoke-evacuation pencil was reported by surgeons?

A. It emitted too much heat

B. It was too short

C. It impaired visualization due to its high-profile design

D. It required both hands to use

E. It malfunctioned intermittently

Answer: It impaired visualization due to its high-profile design

Explanation: Surgeons noted the high-profile pencil hindered visibility during the procedure.

In Geier 2022 et al., on smoke evacuation in TPLO, which of the following statements best reflects the effect of electrosurgery on ultrafine particle levels during surgery?

A. Electrosurgery reduced particle levels below baseline

B. Electrosurgery had no effect on particle counts

C. Electrosurgery increased particle levels above baseline in both groups

D. Electrosurgery increased particle levels only in the NSE group

E. Electrosurgery had inconsistent effects on particle levels

Answer: Electrosurgery increased particle levels above baseline in both groups

Explanation: Electrosurgery significantly raised particle counts in both groups, regardless of evacuator use.

In Geier 2022 et al., on smoke evacuation in TPLO, what level of protection do standard surgical masks provide against ultrafine surgical smoke particles?

A. Excellent protection

B. Moderate protection

C. Only protection against particles >5 μm

D. Full viral protection

E. Complete filtration of smoke

Answer: Only protection against particles >5 μm

Explanation: Standard surgical masks are not designed to filter particles below 5 μm, offering minimal protection against surgical smoke.

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