PORT SITE ELECTROSURGICAL (DIATHERMY) BURNS DURING SURGICAL LAPAROSCOPY

Background: Direct and capacitive coupling of diathermy current have b een reported as causes of occult injury during surgical laparoscopy. M ethods: 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 necro sis. Prior to surgery the cannulas were randomized to either metal or plastic. Results: Coagulative necrosis was observed at nine electrosur gery port sites compared to only one control (chi(2) = 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 coupl ing to the skin edge across plastic cannulas. The potential exists for bums to other tissues also in close proximity to a cannula used for e lectrosurgery.