When analyzed, smoke from electrosurgical units, commonly known as Bovie smoke, is shown to be quite similar to that of other potentially pathogenic smoke, behaving as a carcinogen, a mutagen and an infectious vector. In addition, particulate matter in smoke is known to have health risks related to inducing inflammatory and allergic responses in susceptible people.

The effect on cell viability of smoke produced during high - frequency electro - surgery has not been previously reported. The aim of this study was to produce smoke in vitro , in a closed environment similar to that encountered in minimal access surgery , and to test its cytotoxic effects on cultured cells.

Lasers have assumed an increasingly important role in otolaryngology-head and neck surgery in the past 10 years, with numerous studies in the literature supporting the use of this modality of treatment for various head and neck diseases.  Relatively little data, however, exist regarding the effects of the smoke or plume byproducts resulting from this surgery.

A novel model system was used to investigate the spread of infectious particles and live cells through the application of lasers commonly used in clinical medicine.  Supernatants from a cell line producing recombinant retroviruses carrying a marker gene were exposed to ER:YAG laser bearms.

Carbon dioxide laser energy is absorbed by intracellular water but not by proteins or nucleic acids. The possibility of dispersing viral DNA during laser therapy of human papillomavirus containing genital infections was explored using a filter hybridization technique.  Samples were taken using dacron swabs from 110 patients in nine separate treatment sessions as wll as from five pre-filter canisters.

The potential hazards of aerosols produced by surgical devices interacting with human tissue and fluids are a source of concern to surgical staff and patients.  Typical devices and procedures that can generate airborne debris are bone saws, surgical drills, electrocautery procedures, and laser surgery.

Papillomavirus DNA has been reported recently in the vapor (smoke plume) derived from warts treated with carbon dioxide laser; this raises concerns for operator saftey. We therefore have studied a group of human and bovine warts to define further the potential risk of wart therapy and to test whether a surgical mask could reduce exposure.

The possibility that laser surgeons might inhale virus particles from laser vapor during the removal of certain lesions has been pointed out by several authors.  The risk, however, is regarded as being low, provided adequate precautions are taken. Safety procedures related to eye protection, smoke evacuator systems, etc. have been established.

These data demonstrate the elevation in blood methemoglodin level occurs acutely due to a smoke component of tissue combustion produced by laser use during laparoscopic procedures. The effect of this prolongs intra-abdominal smoke exposure is seen in some patients as post operative nausea, dizziness and visual disturbances. Increased levels of methemoglobin reduce oxygen carrying capacity to tissues, locally and at distant sites.

Laproscopic procedures which generate smoke confine this toxic material to the intra-abdominal cavity. Absorption of portions of this material may occur via the peritoneal absorption. To evaluate whether smoke generated by by this process is absorbed, a study of changes in blood concentration of methemoglobin was designed.