Port site electrosurgical (diathermy) burns during surgical laparoscopy.
BACKGROUND
Direct and capacitive coupling of diathermy current have been reported as causes of occult injury during surgical laparoscopy.


METHODS
In order to determine the incidence of electrosurgical injury adjacent to metal and plastic cannulas, skin biopsies at 19 port sites used for monopolar electrosurgery were analyzed for coagulative necrosis. Prior to surgery the cannulas were randomized to either metal or plastic.


RESULTS
Coagulative necrosis was observed at nine electrosurgery port sites compared to only one control (chi2 = 4.872; df = 1; 0.05 > p > 0.02). Plastic cannulas afforded no greater protection from skin burns than metal cannulas.


CONCLUSIONS
Burns may be the result of direct or capacitive coupling to metal cannulas or capacitive coupling to the skin edge across plastic cannulas. The potential exists for burns to other tissues also in close proximity to a cannula used for electrosurgery.
Willson
P D
PD
Academic Surgical Unit, Royal London Hospital, London, E1 1BB, United Kingdom.
van der Walt
J D
JD
Moxon
D
D
Rogers
J
J
D001706:Biopsy; D002058:Burns, Electric / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D003972:Diathermy / Q000009:adverse effects* / Q000295:instrumentation; D004566:Electrodes; D004598:Electrosurgery / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications; D008670:Metals; D009336:Necrosis; D010969:Plastics; D012867:Skin / Q000473:pathology
D008670:Metals; D010969:Plastics