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.