Risk of viral contamination during surgical care
Several viruses have been implicated to different degrees in the contamination of HCPs during surgery: human immunodeficiency virus (HIV), hepatitis B virus (HBV), bovine papilloma virus and human papilloma virus (HPV). Most of the studies published on the risk of transmission have used in vitro analyses. Several studies have focused on HPV (during the treatment of warts or condylomas) with cases of laryngeal papillomatosis, recognised as an occupational illness in one nurse [2]. In the 2000s, it was difficult for researchers to measure the biological activity of viral DNA in order to assess its infectiousness [3]. However, viable HIVs have been found in cell cultures, especially when aerosol-generating devices are used, although the viability of HIVs is still being debated, and the potential risk of contamination by smoke has not been quantifiable. [4], [5].
For both HPV and HIV, most authors conclude, however, that it is preferable to take all necessary precautions against surgical smoke when operating on infected patients.
There is to our knowledge no large-scale epidemiological study that proves a direct link between a patient's viral load and the contamination of HCPs by emitted surgical smoke. It should also be noted that the published studies have mainly been on surgical smoke from operations on skin or genital lesions. Few studies have evaluated the risk of contamination of HCPs during laparoscopy.
One small-sample study (n  = 11) analysed the presence of HBV in surgical smoke during conventional and robot-assisted laparoscopies [6]. The aerosol from the pneumoperitoneum was trapped in a filter, where the authors found HBV in 10 instances out of 11. This study thus showed the presence of HBV in pneumoperitoneum gas during surgical laparoscopy. The subject matter of this study comes closest to the issue addressed in this article.