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The harmonic scalpel: an intraoperative complication
1Vincent Memorial Obstetrics and Gynecology Service, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Obstetrics and Gynecology
|October 1, 1996
Summary
A rare complication of harmonic scalpel use in laparoscopic surgery is sigmoid colon injury. Bending the instrument can cause overheating and increase tissue injury risk.
Area of Science:
- Surgical Technology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- The harmonic scalpel is an ultrasonically activated surgical device for tissue dissection.
- Expanding applications in minimally invasive surgery have not been accompanied by reports of complications.
Observation:
- A case report details a 35-year-old woman who sustained a sigmoid colon injury during laparoscopic pelvic adhesion lysis.
- The injury was caused by the harmonic scalpel during the procedure.
Findings:
- Acoustic energy coupling and overheating of the laparosonic blade extender sheath can occur when the instrument is bent.
- This phenomenon increases the risk of adjacent tissue injury during laparoscopic procedures.
Implications:
- Awareness of potential harmonic scalpel complications, such as iatrogenic bowel injury, is crucial.
- Careful instrument manipulation, particularly during bending, is necessary to mitigate risks in laparoscopic surgery.