Complications in Surgical Diathermy: Causes and Prevention
Main Article Content
Abstract
Surgical Diathermy is process that involves transmitting high-frequency alternating current through the body to achieve a specific surgical outcome. It is a great tool in surgical practice for dissection and heamostasis, making the dissection precise and minimizes blood loss. It has been used in various surgical specialties, but it has its inherent complications. It can produce a spectrum of complications from minor surgical burns, tissue injuries, nerve palsies, and even major fire incidents in the operation theatre. This review article examines the causes of the complications during the surgery and possible preventive measures. We have searched articles published about the diathermy during the period 1975 to 2025 for analyzing the causes, design modifications in the diathermy, and management of risk. We have also tried to make a protocol for the safety of diathermy usage in the operating theatre. From analysis of previous articles it was found that the complication can be reduced by regular inspections and maintenance, use of safety features, proper patient preparation, effective smoke evacuation, mandatory training, and implementing institutional safety protocols.
Article Details
How to Cite
HAMID, Anwar Marthya; KARUPPAL, Raju; HANNAH, Fathma.
Complications in Surgical Diathermy: Causes and Prevention.
Medical Research Archives, [S.l.], v. 13, n. 6, june 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6625>. Date accessed: 15 july 2025.
doi: https://doi.org/10.18103/mra.v13i6.6625.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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39. Aiolfi A, Scolari F, Fumagalli C, et al. Safety and efficacy of Thunderbeat™ in abdominal surgery: systematic review and meta-analysis. Surg Technol Int. 2015;27:65-70.
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42. Chen PC, Sirjani D, MacDonald B, et al. Artificial intelligence in surgical energy application. Ann Surg. 2022;276(1):e19-e27.
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2. Meeks GR, Rose GS, Brancazio LR, Austin JM. Fatal gas embolism during operative hysteroscopy. J Gynecol Surg. 1994;10(3):141-146.
3. Cushing H. Electro-surgery as an aid to the removal of intracranial tumors. Surg Gynecol Obstet. 1928;47:751-784.
4. Bovie WT. The use of high frequency currents in surgery. Boston Med Surg J. 1928;199:130-136.
5. McFalls M, Lewis BL. Diathermy burn injury during laparoscopic surgery. J Minim Invasive Gynecol. 2007;14(5):650-652.
6. Goudie EB, Miskovic D, El Boghdady M. Electrosurgery and thermal injury: a clear and present danger. Int J Surg. 2020;79:35-41.
7. Brill AI, Nezhat CH. Complications of electrosurgery. Clin Obstet Gynecol. 2009;52(3):540-548.
8. Robinson TN, Stiegmann GV. Minimally invasive surgery and electrical injuries. Surg Endosc. 2007;21(8):1216-1219.
9. Fitzgerald JE, Malik M, Ahmed I. Electrosurgery: history, principles and current and future uses. J Surg. 2012;10(2):66-70.
10. Kopelman D, Orenstein A, Mizrahi S. Diathermy-induced burns: hazards and preventive measures. Burns. 2010;36(3):359-362.
11. Dobbie JW. The surgical ligature: a historical review. J R Coll Surg Edinb. 1996;41(6):416-422.
12. Reilly JP. Applied Bioelectricity: From Electrical Stimulation to Electropathology. Springer; 1998.
13. Vilos GA, Rajakumar C, Montgomery B. Electrosurgical generators and monopolar and bipolar electrosurgery. J Minim Invasive Gynecol. 2015;22(4):559-570.
14. Tucker RD. Laparoscopic electrosurgical injuries: survey results and their implications. Surg Laparosc Endosc. 1995;5(4):311-317.
15. Moossa AR, Easter DW, Van Sonnenberg E. Complications of monopolar electrosurgery: the potential for patient injury. Am J Surg. 1984;147(6):766-768.
16. Ghosh S, Saleh GM. Energy devices in ophthalmic surgery. Eye (Lond). 2007;21(9):1146-1151.
17. Sankaranarayanan G, Resapu RR, Jones DB, Schwaitzberg SD, De S. Common uses and complications of energy in surgery. Surg Endosc. 2013;27(9):3056-3072.
18. Milsom JW, Bohm B, Hammerhofer KA, Fazio VW. Prospective randomized trial comparing ultrasonic and electrosurgical dissection in laparoscopic colorectal surgery. Dis Colon Rectum. 2001;44(6):846-852.
19. Ito M, Sugito M, Kobayashi A, Nishizawa Y. Use of ultrasonic dissection in laparoscopic colorectal cancer surgery. Surg Endosc. 2004;18(5):808-812.
20. Sutton C. Energy sources for laparoscopic surgery. J Minim Invasive Gynecol. 2006;13(4):245-253.
21. Soper NJ, Barteau JA, Clayman RV. Laparoscopic cholecystectomy: the experience of the Washington University group. Surg Clin North Am. 1992;72(5):1037-1056.
22. Diamantis T, Kontos M, Arvelakis A. Insulation failure in laparoscopic instruments. Surg Laparosc Endosc Percutan Tech. 2009;19(3):191-194.
23. Fiek M, Dorwarth U, Dagres N, et al. Safety of monopolar electrosurgery in patients with implantable cardioverter defibrillators: a randomized study. Europace. 2009;11(8):1004-1009.
24. Crossley GH, Poole JE, Rozner MA, et al. The Heart Rhythm Society expert consensus statement on the perioperative management of patients with implantable defibrillators, pacemakers. Heart Rhythm. 2011;8(7):1114-1154.
25. Barrett WL, Garber SM. Surgical smoke—a review of the literature. Is this just a lot of hot air? Surg Endosc. 2003;17(6):979-987.
26. Ilce A, Yuzden GE, Yavuz van Giersbergen M. Exposure of operating room nurses to surgical smoke. J Clin Nurs. 2017;26(11-12):1552-1561.
27. Massarweh NN, Cosgriff N, Slakey DP. Electrosurgery: history, principles, and current and future uses. J Am Coll Surg. 2006;202(3):520-530.
28. Feldman LS, Fuchshuber PR, Jones DB. The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE). Springer; 2012.
29. Nduka CC, Super PA, Monson JR, Darzi AW. Cause and prevention of electrosurgical injuries in laparoscopy. J Am Coll Surg. 1994;179(2):161-170.
30. Rozner MA. The patient with a cardiac pacemaker or implanted defibrillator and management during surgery. Curr Opin Anaesthesiol. 2007;20(3):261-268.
31. Mimica M, Vranesic Bender D, et al. Skin injuries from electrosurgery in at-risk patients: incidence and consequences. Acta Dermatovenerol Croat. 2017;25(1):40-46.
32. Ball K. Surgical smoke evacuation guidelines: compliance issues. AORN J. 2010;92(2):130-142.
33. Jayaraman S, Davies W, Schlachta CM. Training and skill assessment in electrosurgery: the FUSE curriculum. Can J Surg. 2014;57(2):E47-E50.
34. Bertin F, Chevallier JM. The VIO electrosurgical unit. J Vis Surg. 2008;145(5):205-209.
35. Kennedy JS, Stranahan PL, Taylor KD, Chandler JG. High-burst-strength, feedback-controlled bipolar vessel sealing. Surg Endosc. 1998;12(6):876-878.
36. Milone M, Musella M, Maietta P, et al. Safety and efficacy of LigaSure in laparoscopic colorectal surgery. Updates Surg. 2013;65(3):201-205.
37. Amaral JF. The experimental development of an ultrasonically activated scalpel for laparoscopic use. Surg Laparosc Endosc. 1994;4(2):92-99.
38. Kamenova P, Petkov T, Drangova M, Kirova G. Comparative analysis of the surgical outcomes using harmonic scalpel versus electrocautery. J IMAB. 2017;23(4):1774-1778.
39. Aiolfi A, Scolari F, Fumagalli C, et al. Safety and efficacy of Thunderbeat™ in abdominal surgery: systematic review and meta-analysis. Surg Technol Int. 2015;27:65-70.
40. Kaye K, Kwok AC, Brownlee SA, et al. Current applications and future trends in robotic surgery. Am J Surg. 2021;222(5):903-911.
41. Berguer R. Electrosurgical injuries: mechanisms and prevention. AORN J. 1997;66(6):1031-1042.
42. Chen PC, Sirjani D, MacDonald B, et al. Artificial intelligence in surgical energy application. Ann Surg. 2022;276(1):e19-e27.
43. Kuramoto Y, Sasaki Y, Ohta M, et al. Augmented reality surgical navigation with thermal visualization. Int J Comput Assist Radiol Surg. 2020;15(6):1025-1031.