Surgical smoke or plume is a gaseous product generated by electrosurgical devices (monopolar cautery, electrothermal bipolar graspers and ultrasonic shears) for dissection and haemostasis. These devices transfer thermal energy, and disrupt and vaporise tissues by intracellular boiling, cell explosion and steam release. While surgical plume dissipates slowly at open surgery, it accumulates within a pressurised cavity during minimally invasive surgery (MIS) such that evacuation via surgical ports is needed (and it is more concentrated). This has raised concerns about occupational mutagenic, cytotoxic and infective risks because surgical plume may be a source of viral transmission to operating room staff. Genetic material from hepatitis B virus, human immunodeficiency virus and human papillomavirus virus has been found in surgical plume. Heat and moisture exchange (HME) or underwater filters have been proposed to mitigate risk during the current pandemic. This experimental study aimed to see if viable coronavirus was detectable in electrosurgical plume and evaluated filtration options for reducing viral exposure.

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