Is Surgical Smoke More Harmful than Cigarette Smoke?

In the United States, there are very few businesses that still allow for smoking indoors. The negative impact on people’s health has been well documented at this point. The harmful substances in the ordinary cigarette can lead to the risk of conditions like lung cancer or heart disease. At this point, we’ve all come to expect the dangers of smoking or secondhand smoke.

What would surprise most people is that you could be exposed to smoke just as dangerous within the walls of a hospital operating room. Surgical smoke can be made up of toxic vapors, bioaerosols, viruses, blood fragments, and dead or living cell material. This smoke is created by any surgery that uses ultrasonic or electrocautery devices. It can be caused by drills or bone saws. One study has shown that surgical smoke could be even more dangerous than tobacco smoke.

The Dangers of Surgical Smoke

The experts in this study used a carbon dioxide laser on one gram of tissue. Following that, the experts destroyed another identical gram of tissue with an electrosurgical current. The chemical offshoots that were made by the laser smoke were compared to the chemical exhaust of average tobacco smoke. The results were troubling for surgical staff everywhere. reports the outcome, “The results showed that the laser smoke generated from one gram of tissue was equivalent to smoking three unfiltered cigarettes. The electrosurgical smoke was equivalent to smoking six unfiltered cigarettes.”

This surgical exhaust can also contain mutagens that can cause genetic mutations in those exposed. Another carcinogen, called formaldehyde, was also found in various levels. The outcome of this research has convinced the Association of periOperative Registered Nurses and the National Institute for Occupational Safety and Health to push for removing smoke from operating rooms. There are two main paths to reducing the amount of surgical smoke in these rooms.

Two Ways to Reduce Surgical Smoke

  1.  The fastest way to reduce this threat is the practice of surgical smoke evacuation. These smoke evacuation systems are high-flow vacuums that would pull the smoke and gases straight from the surgical source. The use of these devices would enhance patient care. It is the quickest way of making the operating table safer from surgical smoke.
  2.  The slower yet long-term solution is creating new products that reduce the creation of surgical smoke. Andrew Ekdahl, President of Ethicon US, has said, “At Ethicon, we are focused on addressing unmet healthcare needs, and reducing exposure to surgical smoke in the OR is a top priority.”

Ethicon is working on both paths to improve the state of surgery rooms. Their efforts include the Megadyne smoke evacuation pencils, as well as, new devices that make less smoke. Their latest invention in this crusade is the Megadyne Ace Blade 700 soft tissue dissector. According to, “This device is powered by patented Geometric Electron Modulation (GEM) technology, which achieves a scalpel-like cutting effect by creating a low-voltage plasma.” This tool creates a smaller amount of smoke by using energy more cleanly and delivers a constant flow of power.

Put into practice, this means that the same amount of energy is dealt to the tissue despite the interference. The results have been very successful so far. According to Ethicon, the Ace Blade creates 99.6% less surgical smoke than monopolar electrosurgery. It has also shown a 97% reduction in the harmful carcinogen, BaP.

What’s Next?

 We still have a long way to go. Our healthcare buildings must do more to protect patients and their staff, but machines like these are great first steps. This smoke is created by some of the most advanced treatments and we know every treatment has side effects. In the future, we can hope for breakthroughs that provide the same care without the toxic results.