Objective: To determine the chemical composition of surgical smoke produced during transurethral resection of the prostate (TURP) and vaporization.
Methods: A total of 12 smoke samples were collected from a continuous irrigation suction drainage system to a Tenax absorber at a 0.05 L/min flow rate during TURP and vaporization. The gases were quantitatively and qualitatively analyzed by gas chromatography-mass spectrometry (GC-MS) equipped with a purge and trap sample injector.
Results: The main chemical constituents of surgical smoke produced during TURP and vaporization include propylene, allene, isobutylene, 1,3-butadiene, vinyl acetylene, mecaptomethane, ethyl acetylene, diacetylene, 1-pentene, EtOH, piperylene, propenylacetylene, 1,4-pentadiene, cyclopentadiene, acrylnitrile and butyrolactone. Three of the constituents are very toxic and carcinogenic (1,3-butadiene, vinyl acetylene and acrylonitrile). The amount (mean ± standard deviation) of chemical components in the 45 L of gas and room air mixture produced during TURP and vaporization were as follows: propylene, 0.80 ± 0.52 mg; isobutylene, 212.85 ± 75.65 mg; 1,3-butadiene, 0.93 ± 0.34 mg; ethyl acetylene, 0.09 ± 0.05 mg; 1-pentene, 6.75 ± 1.62 mg; 1,4-pentadiene, 0.06 ± 0.02 mg; and acrylonitrile, 1.62 ± 1.19 mg.
Conclusions: Three of the toxic gases generated during TURP and vaporization are carcinogens (1,3-butadiene, vinyl acetylene and acrylonitrile). Therefore, higher quality filter masks, smoke evacuation devices and/or smoke filters should be developed for the safety of the operating room personnel and patients during TURP and vaporization.