Quick Safety 69: Preventing burns from laparoscopy and arthroscopy

By Brian Ward

On April 10, The Joint Commission published Quick Safety Issue 69: Preventing light source-related burns from laparoscopy and arthroscopy. Both arthroscopy and laparoscopy are done by inserting a narrow tube and fiber-optic camera into a small incision. For the camera to see anything in the incision, there needs to be adequate lighting, either using lamps or light cables.

“Even momentary proximity between an illuminated laparoscopic or arthroscopic light lead and a surgical drape can cause a full-thickness burn to the patient’s skin without generating any smoke or fire. The risk of thermal injury rises with the brightness of the lamp used,” The Joint Commission added.

The Joint Commission warns that equipment malfunctions can cause lighting sources to overheat, sometimes reaching temperatures of up to 268.6 Celsius (515.48 F) at the tip of the optical cable. Detached light cables resting against surgical drapes can also burn or permanently scar patients.

“Burns from these types of light sources can go unnoticed by the surgical team because they typically do not produce smoke or charring, even of surgical drapes,” The Joint Commission wrote.

Suggested safety actions include:

  • Educate all providers involved in these procedures about proper scope handling
  • Label light sources with a heat warning
  • Don’t turn on the light source before the cable is connected to the scope
  • If the cable is disconnected from the scope during surgery, hold the cable end away from the drapes or place it on a moist towel
  • Keep illuminated light cords away from drapes, patient's skin, personnel's skin, and any flammable material
  • Connect the correct size light source to the correct scope

Inspect all instruments and equipment before use. Click here to read Quick Safety Issue 69.  

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Joint Commission, Patient Safety