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Complications from Monopolar Electrosurgery

According to an article published in Surgical Endoscopy, monopolar electrosurgery is the preferred technique for tissue cutting and for stopping bleeding during gallbladder surgery.  However, the combination of monopolar electrosurgery and gallbladder surgery can be dangerous.

 

 Monopolar electrosurgery is utilized by more than 85% of surgeons who perform laparoscopic gallbladder surgeries.  Although the procedure is popular, cost-effective and versatile, there is also an increase in complications, which includes thermal injuries.  The reduced field of view prevents the surgeon from directly observing any tissue located away from the tip of the active electrode.  Because of this restricted view the surgeon is less likely to detect thermal damage caused by stray energy.  Electrosurgical burns result from insulation failure or capacitive coupling.  Also, inadvertent burn injuries to non-targeted tissues outside the surgeon’s view can occur.  These can be difficult to diagnose because symptoms are often delayed.  Some of the consequences of thermal injuries are bowel perforation and peritonitis.