A case elucidating a new mechanism of thermal injury in laparoscopic surgery: spread of monopolar electric current in collecting bag.

概要

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Monopolar current is essential in laparoscopic surgery. However complications of monopolar electrosurgery include thermal injury due to wrong contact, capacity coupled current, and shunting . This report deals with a new mechanism of shunting in laparoscopic surgery. The specimen bag is the insulator. In this case, the monopolar current cut tumor in the collecting bag. Typically this can't happen. Electricity should have flowed to the surface of the abdomen. When the bag had full contact with organs it did not cause shunting burns. If there was point contact, shunting burns occurred. We propose that the causes of shunting burns are point-contact and the water in the abdominal cavity. Electrothermal burns are reported more often in laparoscopic surgery than in laparotomy. This report aims to reduce these injuries through understanding of the characteristics of the electric scalpel and water management in the abdominal cavity.