Tucker R D
Department of Pathology, University of Iowa, Iowa City 52242, USA.
Surg Laparosc Endosc. 1995 Aug;5(4):311-7.
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.
本文提供了美国外科医师学会关于腹腔镜手术中电外科并发症及手术技术的调查结果。在受访者中，18%表示他们在腹腔镜手术过程中亲自经历过给患者造成电外科烧伤的情况。调查显示，大多数外科医生（74%）在手术中最常使用凝血模式。在这些外科医生中，超过三分之一的人常规在功率设置>40W时采用高压凝血和混合模式操作。我们讨论了高压高功率设置可能引发的并发症，如直接耦合、绝缘故障以及意外电流通过电容耦合进入肠道等内部组织。我们还进一步描述了可用于将意外电外科烧伤可能性降至最低的技术，以及能够消除或大幅降低电外科并发症可能性的技术。
