• Rana Patir, Sanjeev Ariyandath Sreenivasan, and Sandeep Vaishya.
• Department of Neurosurgery, Fortis Memorial Research Institute, Gurgaon, India.
• World Neurosurg. 2021 Jun 1; 150: 153-160.

ObjectivePresent guidelines on reducing aerosol generation during neurosurgical procedures are futile. The aim of this article was to describe a novel device to contain aerosol within a small localized environment around the operative field-the negative pressure assisted microenvironment surgical hood (NEPA-MESH).MethodsThis device can be assembled using easily available materials-steel wires, image intensifier cover, surgical drape, and three-dimensional-printed self-locking copolyester double hoops. Large-bore pipes in continuity with a high-volume suction apparatus create a constant negative pressure microenvironment around the operative field. The CEM DT-9880 particle counter was used to estimate particle concentration inside the NEPA-MESH during various stages of a neurosurgical procedure as well as outside. The NEPA-MESH was tested in different craniotomies and endoscopic procedures.ResultsMean particle concentration inside the NEPA-MESH and outside during drilling in various procedures was calculated and compared using unpaired t test. Significant reduction in particle concentrations was recorded for particles sized 0.3 μm (t = 17.55, P < 0.0001), 0.5 μm (t = 11.39, P < 0.0001), 1 μm (t = 6.36, P = 0.0002), 2.5 μm (t = 2.04, P = 0.074), 5.0 μm (t = 7.026, P = 0.0008), and 10 μm (t = 4.39, P = 0.0023).ConclusionsAs definitive evidence demonstrating the presence of coronavirus disease 2019 (COVID-19) in aerosol particles is awaited, we describe a cost-effective strategy to reduce aerosol contamination. Significant reduction in particle concentrations was seen outside the NEPA-MESH compared with inside it during various stages of neurosurgical procedures.Copyright © 2021 Elsevier Inc. All rights reserved.

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