Incidental bronchial injury by soft coagulation

Soft coagulation is a specific mode of VIO electrosurgical units (ERBE Elektromedizin, Tubingen, Germany), which provides dramatic hemostasis during various types of surgery. The most characteristic feature of this device, when compared with the ordinary electrosurgical units, is that it automatically regulates its output voltage below 200 V, which denatures the target protein between 70 and 80 °C. This low-temperature coagulation enables hemostasis of large blood vessels, without carbonizing or damaging the bleeding point and the surrounding tissue (1,2). In thoracic surgery, accidental damage to the surrounding organs, such as the pulmonary artery, leads to critical bleeding. Using this atraumatic device in thoracic surgery improves the safety of major pulmonary resection. We routinely use this device in our surgery as a countermeasure for unexpected intraoperative bleeding, using a ball electrode tip and setting the system at effect 5 and 60 W. Surgery has become safe and comfortable with the advent of this technology