An underreported complication of laparoscopic surgery

Electrothermal injuries have been estimated at 1 to 5 events per 1,000 cases (1). However, their true incidence is unknown and is likely underreported. Most of the injuries are unrecognized at the time of occurrence and are only diagnosed post‐operatively or even treated without determining the exact cause .
In a survey of 506 attendants at the American College of Surgeons, 18% of surgeons reported that they had personally experienced an electrosurgical burn and 54% knew of a colleague who had a patient with an electrosurgical injury (2).

How does it happen?

During laparoscopic surgery, stray current generated from the electrosurgical instrument can be transmitted to other nearby conductors, and ultimately to patient tissue, in the following ways:

– By direct contact (direct coupling)
– Without direct contact (capacitive coupling)
– Due to insulation failure of the instruments

… leading to significant morbidity and mortality (3, 4).