Complications of Electrosurgery in Laparoscopy: A Review Study

Background and Objective: The Electrosurgery is one of the most commonly used energy systems in laparoscopic surgery. Due to its accessibility and favorable technical outcomes, monopolar generator is still the preferred tool for conventional laparoscopic surgery.Two major categories of potential complications related to electrosurgery in laparoscopy are mechanical trauma and electrothermal injury. Electrothermal injuries derive from insulation failure, direct coupling, and/or capacitive coupling. These injuries aren’t apparent or go unrecognized initially, due to their location beyond the laparoscopic visual field.Unlike insulation failure and direct coupling, which cause direct electro-thermal damage to unintended target tissues, capacitive coupling is a rarely reported electrosurgical complication that releases stray current into non-targeted tissues. However, some reports have indicated lack of sufficient knowledge and training about basic principles and technical aspects of electrosurgery among laparoscopic procedure. This review article focuses on preventing such complications.Search Method: A search of the PubMed,googlescholar,Ovid,Elsevier and ProQuest database was carried out using the following phrase: laparoscopy , Electrosurgical safety , complications and principle , Electrothermal injuries resulting in 71 articles. After exclusion of 5 non-English language articles, the remaining 66 abstracts were examined. Of these, a further 43 articles were deemed irrelevant as they did not focus on the topic in question, 10 did not include period of 2006-2019. The remaining 13 papers were read in detail and used.Findings: we reviewed the literature concerning Electrothermal injuries and principles of electrosurgery. Surgeons can minimize capacitive coupling energy during laparoscopy by lowering the power setting, using cut mode (instead of coagulation), using the surgical technique of desiccation (instead of open air activation or fulguration).Conclusion: To achieve electrosurgical safety and to prevent electrosurgical injuries, the surgical team should have a good understanding of the biophysics of electrosurgery, the basis of equipment and general tissue effects, as well as the surgeon’s spatial orientation and hand-eye coordination.

Keywords:

Electrosurgery , Laparoscopy , Complications