OP E R ATING THEATR E S
protection too, in an attempt to protect themselves from the surgical plume. However, masks only offer partial protection and leave individuals vulnerable to inhaling the smaller particulates that can still infiltrate through the mesh or fabric. More advanced respirator masks are available that prevent this, but they are not routinely used. Removal of the plume itself is seldom tackled directly, but is generally left to standard room ventilation, which is inadequate, not least because the plume has to pass the individuals before it disappears into the fan systems of an entire room.
A new plume evacuation device for colposcopy
The issue of surgical plume is an area of specialist interest in its own right, not least because of the health ramifications if it is ignored. Steve Veck is one of the leading experts in the field, having worked as a consultant in electrosurgery for over 30 years. A member of the International Council on Surgical Plume, he regularly teaches on the topic of electrosurgery and surgical
plume to universities and organisations across the world. Steve has been directly involved in the design and development process of plume evacuation kits over the years, the latest being a partnership with the UK-based medical device company, June Medical.
He explained: “Previous devices designed to remove surgical plume involved large
industrial air-filtration systems that sat somewhere within the operating room but typically at quite a distance from the patient. However, the only effective way to remove surgical plume is to capture it within a very short distance from where it is produced. The compact plume evacuation kits we have developed achieve this by directly connecting to the speculums and immediately eliminating the surgical plume from the operating site within the vaginal canal, disposing of it before there is any chance of it escaping and being exposed to the patient and surrounding staff.”
Plume evacuation
HPV’s carcinogenic properties are known to be implicated in the pathogenesis of oropharyngeal cancers and there is substantial evidence demonstrating that traces of the virus can be identified in the nasal and oral mucosa of staff following their involvement in gynaecological surgery. Inhaling the plume during these procedures carries a very real threat of serious disease in exposed individuals.
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Steve’s most recent collaboration with June Medical has seen further adaptations to a previous model, resulting in the new eVeck Colposcopy Plume Evacuation Kit, a single-use product that works in real time to constantly remove the surgical plume as it is generated. It includes tubing that is linked to a flexi connector compatible with a range of speculums of variable sizes at one end, and to the plume evacuation generator at the other. There is also a high-efficiency particulate air (HEPA) pre-filter integrated within the tubing to partially treat the plume before it reaches the main evacuation generator. “A very important improvement is to the tubing, which has been reinforced to minimise crushing or kinking during the procedure and maintain patency,” Steve explained.
“It is also a much lighter weight, which is more comfortable for patients because, when they are lying in the lithotomy position with their legs in stirrups, the tubing passed over the leg can be heavy and cumbersome. This product also has significantly fewer connections and fixations than previous models, which makes it both more efficient because there is less resistance to flow, and more robust with less chance of parts deteriorating and needing replacing.” He added that the new design ensures that the surgical plume first passes through
MARCH 2021
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