Capacitive coupling leading to electrical skin burn injury during laparoscopic surgery
10.7602/jmis.2022.25.3.106
- Author:
Woo Jun KIM
1
;
Gyung Mo SON
;
In Young LEE
;
Sung Uk YUN
;
Gye Rok JEON
;
Dong-Hoon SHIN
;
Myung Sook KWON
;
Jae Yeong KWAK
;
Kwang-Ryul BAEK
Author Information
1. Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Journal of Minimally Invasive Surgery
2022;25(3):106-111
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Trocar-site burns occurring during laparoscopic surgery have been reported in various cases, and several efforts to reduce them are underway. This study aimed to analyze the effect of capacitive coupling on trocar site by observing electrical and histological changes for electrical skin burn injury.
Methods:To measure the electrical changes relating to capacitive coupling, the temperature, current, voltage, and impedance around the trocar were measured when an open circuit and a closed circuit were formed using insulation intact instruments and repeated after insulation failure. After the experiment, the tissue around the trocar was collected, and microscopic examination was performed.
Results:When open circuits were formed with the intact insulation, the impedance was significantly reduced compared to the cases of closed circuits (142.0 Ω vs. 109.3 Ω, p = 0.040). When the power was 30 W and there was insulation failure, no significant difference was measured between the open circuit and the closed circuit (147.7 Ω vs. 130.7 Ω, p = 0.103). Collagen hyalinization, nuclear fragmentation, and coagulation necrosis suggesting burns were observed in the skin biopsy at the trocar insertion site.
Conclusion:This study demonstrated that even with a plastic trocar and electrosurgical instruments that have intact insulation, if an open circuit is formed, capacitive coupling increases, and trocar-site burn can occur. When using electrocautery, careful manipulation must be taken to avoid creating an open circuit to prevent capacitive coupling related to electrical skin burn.
