Journal article
Education and engineering solutions for potential problems with laparoscopic monopolar electrosurgery
The American journal of surgery, Vol.164(1), pp.57-62
1992
DOI: 10.1016/S0002-9610(05)80648-8
PMID: 1385675
Abstract
The potential problems of monopolar electrosurgery relate to unrecognized energy transfer (“stray current”) outside the view of the laparoscope. Mechanisms of stray current and uncrecognized tissue injury include: (1) insulation breaks in electrodes; (2) capacitive coupling, or induced currents through the intact insulation of the active electrode to surrounding cannulas or other instruments; and (3) direct coupling (or unintended contact) between the active electrode and other metal instruments or cannulas within the abdomen. Capacitive coupling poses the greatest risk for injury when the outer conductor (trocar cannula or irrigation cannula) is electrically isolated from the abdominal wall by a plastic nonconductor. Capacitive coupling is increased by the coagulation mode (versus cut), open circuit (versus tissue contact with the electrode), 5-mm cannulas (versus 11 mm), and higher voltage generators.
The safety of electrosurgery can be enhanced by surgical education regarding the biophysics of radio frequency electrical energy, technical choices in instruments using all-metal cannula systems, and engineering developments with a dynamically monitored system for insulation failure and capacitive coupling.
Details
- Title: Subtitle
- Education and engineering solutions for potential problems with laparoscopic monopolar electrosurgery
- Creators
- C. Randle Voyles - Jackson, Mississippi, USARobert D Tucker - Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- The American journal of surgery, Vol.164(1), pp.57-62
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0002-9610(05)80648-8
- PMID
- 1385675
- ISSN
- 0002-9610
- eISSN
- 1879-1883
- Language
- English
- Date published
- 1992
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Pathology
- Record Identifier
- 9984047977702771
Metrics
14 Record Views