Laparoscopic electrosurgical injuries: survey results and their implications

This article provides the results of a survey on electrosurgical complications and surgical techniques during laparoscopy from the American College of Surgeons. Of the respondents, 18% stated that they had personally experienced an electrosurgical burn to their patient during laparoscopy. The survey shows that the majority of surgeons, 74%, employ coagulation mode most commonly during surgery. Of the surgeons, more than one third routinely employ high-voltage coagulation and blend mode operation at power settings > 40 W. We discuss the possible complications that may occur from high-voltage-high-power settings, such as direct coupling, insulation failure, and capacitive coupling of unintended current into internal tissue such as bowel. We further describe techniques that may be employed to minimize the likelihood of unintended electrosurgical burns as well as technologies that can eliminate or greatly decrease the likelihood of electrosurgical complications.