Comparative analysis of the results of laparoscopic cholecystectomy using the protocol of electrosurgical safety and evacuation of surgical smoke

Introduction. Electrosurgical methods are widely used in general and endoscopic surgery, but their use is accompanied by the formation of so-called surgical smoke, which contains many toxic substances. In addition to the health effects of smoke, electrosurgery itself carries a number of characteristic risks. The presence of smoke in the surgical area impairs the visibility of the surgical field. In laparoscopy, this problem is aggravated by the confined space of the abdominal cavity. The purpose of the study. To conduct a comparative analysis of the results of laparoscopic cholecystectomy using a protocol for safe operation with electrosurgical equipment and with active evacuation of surgical smoke, and without using this protocol. Materials and methods. A comparative analysis of the results of laparoscopic cholecystectomy performed in 507 patients with chronic calculous cholecystitis at the surgical department in 2021-2024 was carried out. The patients were divided into two groups: the control group (n = 252) consisted of patients who underwent a standard laparoscopic cholecystectomy technique using an electrosurgical instrument without special smoke evacuation; The study group (n = 255) consisted of patients who underwent laparoscopic cholecystectomy performed using the author's protocol for safe operation with electrosurgical equipment and with active evacuation of surgical smoke. Results. We have developed a checklist of measures for safe operation with electrosurgical equipment and with active evacuation of surgical smoke. The application of the developed protocol made it possible to increase the safety of the intervention for the patient. Discussion. Our study shows that the introduction of a standardized protocol for safe electrosurgery with active smoke evacuation in CCE can simultaneously improve intraoperative conditions (visualization, coagulation control) and reduce the incidence of a number of complications without increasing the duration of the intervention. Conclusion. The introduction of a protocol for safe operation with electrosurgical equipment with active evacuation of surgical smoke significantly improves the conditions for laparoscopic surgery. The author's protocol demonstrates a high level of safety for the patient and reduces the incidence of various postoperative complications, including burn injuries.