Abstract Monopolar electrosurgical pencils are used extensively in surgical operations. With such pencils, electric current passes to the tissue, and as such, electrosurgical pencil operation generates a significant amount of thermal energy, which in turn leads to the generation of electrosurgical smoke (ES). The health risks of ES are dependent on the size distributions as well as the morphologies of the produced particles. To better characterize such particles, in this study we utilized (1) differential mobility analysis with a condensation particle counter (DMA-CPC), (2) an aerodynamic particle spectrometer (APS), (3) DMA-transmission electron microscopy analysis (DMA-TEM), and (4) DMA-aerosol particle mass analysis (DMA-APM) to examine the size distribution and morphologies of particles produced during simulated operation of an electrosurgical pencil (Neptune E-SEP, Stryker Corporation) on bovine, porcine, and ovine tissue. We find that under a variety of operating conditions, ES particles are broadly distributed, with a mode mobility diameter in the 150–200 nm size range, and concentrations well above background levels in the 50 nm–5 μm size range. We also find that the “cut” mode of monopolar electrosurgical pencil operation generates higher particle concentrations than the “coagulate” mode, and that increasing the maximum applied power from 20 W to 50 W also increases ES particle concentrations. TEM images of mobility selected particles reveal both spherical particles and fractal-like agglomerates in ES; these different particle types are produced under the same operation conditions leading to an externally-mixed, morphologically-complex aerosol. Quantitative analysis of the agglomerate images revealed that agglomerates have an average fractal dimension near 1.93 and that they are structurally similar to agglomerates expected from a diffusion limited cluster aggregation growth mechanism. Despite the presence of both spheres and agglomerates, DMA-APM analysis reveals that all particles have effective densities in the 1000–2000 kg m−3 range, suggesting that they likely contain inorganic components. Finally, we determined that the collection efficiency of the ES capture suction unit attached to the electrosurgical pencil was >95% for particles in the 50–400 nm mobility diameter range.

中文翻译：

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从单极电外科铅笔发射的粒子的形态特征

摘要 单极电外科铅笔广泛用于外科手术。使用这种铅笔，电流会传递到组织，因此，电外科铅笔操作会产生大量的热能，进而导致产生电外科烟雾 (ES)。ES 的健康风险取决于产生的颗粒的尺寸分布和形态。为了更好地表征此类粒子，在本研究中，我们使用了 (1) 带有凝聚粒子计数器 (DMA-CPC) 的差分迁移率分析，(2) 空气动力学粒子光谱仪 (APS)，(3) DMA 透射电子显微镜分析 (DMA) -TEM), (4) DMA-气溶胶颗粒质量分析 (DMA-APM)，以检查在牛、猪和绵羊组织上模拟操作电外科铅笔（Neptune E-SEP，Stryker Corporation）期间产生的颗粒的尺寸分布和形态。我们发现在各种操作条件下，ES 粒子分布广泛，模式迁移率直径在 150-200 nm 尺寸范围内，浓度远高于 50 nm-5 μm 尺寸范围内的背景水平。我们还发现，单极电外科手术铅笔操作的“切割”模式比“凝固”模式产生更高的粒子浓度，并且将最大施加功率从 20 W 增加到 50 W 也会增加 ES 粒子浓度。迁移率选定粒子的 TEM 图像显示 ES 中的球形粒子和分形状团聚体；这些不同的颗粒类型是在相同的操作条件下产生的，导致外部混合、形态复杂的气溶胶。团聚体图像的定量分析表明，团聚体的平均分形维数接近 1.93，并且它们在结构上与扩散受限的簇聚集生长机制所预期的团聚体相似。尽管存在球体和团聚体，但 DMA-APM 分析表明所有颗粒的有效密度都在 1000-2000 kg m-3 范围内，表明它们可能含有无机成分。最后，我们确定连接到电外科笔的 ES 捕获抽吸装置的收集效率 > 95%，对于 50-400 nm 移动直径范围内的颗粒。