J.J.ANG1, D.K.A. CHIA1, P.A. TAMBYAH1, S.H. LAU2, J. ONG2, V.T.K. CHOW2, D.A. ALLEN2, J. FUNG1, K. LAU3, I. LUGUNG3, S. SCHUSTER3
National University Hospital1, National University of Singapore2, Nanyang Technological University3
Infective risks from surgical plume pose a hazard to healthcare workers and remain unquantified. There is a paucity of data to support the use of Heat and Moisture (HME) filters or disinfectants in eradicating viruses as proposed by some authors. Our objective is to determine and quantify live coronavirus in surgical smoke generated by electrosurgical devices and to determine if HME filters or disinfectants are effective in inactivating live coronavirus.
Monopolar, bipolar and ultrasonic electrosurgical devices were applied to lamb meat inoculated with live coronavirus (Murine Hepatitis Virus: MHV-A59) in a laparoscopic setup. Nebulized MHV-A59 was also passed through a HME filter (DAR™ COVIDIEN Adult-Pediatric electrostatic filter, Mansfield, MA, USA) and polyvinylpyrrolidone-iodine or Dettol™. Gaseous waste generated were subjected to real-time quantitative polymerase chain reaction to quantify MHV-A59 RNA and viral culture to determine if MHV-A59-induced cytopathogenic effects (CPE) were present.
No viral RNA or virus-induced CPE was detected in the surgical plume generated by the electrosurgical devices. Gaseous waste after passage of nebulized MHV-A59 through a HME filter yielded a viral RNA count of 34.3 ± 20.6 copies/ml with no virus-induced CPE. Passage of nebulized MHV-A59 through Dettol™ and polyvinylpyrrolidone-iodine yielded an RNA count of 7591 ± 9459 and 1502 ± 307 copies/ml respectively with evidence of cytotoxic effect but no virus-induced CPE.
Electrosurgical devices do not aerosolize viable MHV-A59 coronavirus in a pre-clinical MIS model. Discharging gaseous waste through HME filters or underwater filtration with polyvinylpyrrolidone-iodine or Dettol™ effectively inactivates live coronavirus.