Workplace exposure to carbon dioxide during routine laparoscopy – is it safe?

Background: Minimally invasive surgeries have increased dramatically during the last decades. Carbon dioxide (CO (2)) is the gas used for insufflation during laparoscopies, creating space and visibility. The CO (2 )leaks into ambient air through ports where instruments are inserted. If the CO (2 )reaches a certain concentration it affects personnel health. There are national occupational exposure limits (OEL) for CO (2), including a level limit value (LLV) of 5000 ppm. We are not aware of any previous studies addressing occupational exposure to CO (2 )during laparoscopies. The aim of this study was to assess the compliance to national OELs for CO (2 )during laparoscopies. Methods: A gas detector was placed in the breathing zone of personnel in the operating theatre. The detector measured CO (2 )concentrations every tenth minute during laparoscopies in three locations. Results: During 27 laparoscopies, the measured CO (2 )reached a maximum concentration of 1100 ppm, less than one fourth of the LLV. Median CO (2) concentration was 700 ppm. Conclusion: Results show that the occupational exposure to CO (2 )during laparoscopies is well below set OELs. Our findings support personnel safety associated with routine use of CO (2 )during laparoscopies.