8279960 Real-time impact of surgical vacuum use on air particulate matter during electrocautery procedures

<h3>Objective</h3> Surgical smoke generated during electrocautery procedures contains hazardous particulate matter (PM) such as PM₂.₅ and PM₁₀, which may compromise the respiratory health of operating room personnel. Although vacuum (Vac) systems are commonly used to reduce such exposure, their time-resolved effectiveness across surgical phases remains understudied. This study aims to fill that gap by applying time-normalized analyses to evaluate whether Vac use consistently reduces airborne particulate concentrations during surgery. <h3>Material and Methods</h3> This study analyzed real-time air quality data by DustTrak™ DRX Aerosol Monitor 8533 from 46 laparoscopic cholecystectomy (LC) surgeries conducted in the same operating room. Cases were randomly categorized into full-time Vac use (n=21) and no Vac use (n=15). Concentrations of PM₂.₅, PM₁₀, and total PM were continuously recorded. Surgical time was normalized and divided into 100 equal time bins. Mean pollutant levels across these bins were compared between Vac and non-Vac groups, stratified further by surgical complexity (LC: simple vs. complex). <h3>Results</h3> Vac-use surgeries consistently demonstrated lower PM₂.₅ and PM₁₀ levels across most of the procedure timeline, with statistically significant differences in high-concentration phases (p &lt; 0.01). Total PM also trended lower with Vac use. Subgroup analysis by surgical complexity revealed that complex procedures (n=17) were associated with higher pollutant exposure overall than simple LC (n=29), but Vac implementation helped reduce extreme spikes and smoothed fluctuations. <h3>Conclusion</h3> Full-time use of Vac systems significantly reduces airborne PM exposure, particularly during complex procedures. Ongoing analyses with a larger sample size are underway to further substantiate the evidence supporting Vac implementation as a routine safety standard in electrosurgical protocols.