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Intended and stray radiofrequency electrical currents during resectoscopic surgery
G A Vilos1, S McCulloch, P Borg
1Department of Obstetrics and Gynecology, St. Joseph's Health Centre, 268 Grosvenor Street, London, Ontario, Canada N6A 4V2.
Summary
Electrical burns during surgery can stem from intact or defective electrodes. Defective insulation causes extensive tissue damage, while intact devices may cause thermal injury with prolonged use.
Area of Science:
- Urology
- Surgical Technology
- Biomedical Engineering
Background:
- Hysteroscopic endometrial ablation and transurethral prostatectomy carry risks of electrical injury.
- Capacitive coupling and stray currents from electrosurgical devices are potential causes of these injuries.
Purpose of the Study:
- To investigate the relationship between electrical burns in the genital tract and urethral strictures.
- To determine the role of capacitive coupling and stray currents from intact and defective electrodes/resectoscopes in causing these injuries.
Main Methods:
- In vitro measurements were conducted using porcine muscle and liver.
- Electrical coagulation and cutting currents were measured from rollerball and loop electrodes and resectoscope sheaths.
- Simulated insulation defects were introduced to assess current transfer and tissue damage.
Main Results:
- Capacitive coupling induced 20-25% of current to the resectoscope sheath, causing superficial burns upon contact.
- Defective insulation led to 100% current transfer to the sheath, resulting in extensive electrical burns.
- Intact sheaths acted as dispersive electrodes under normal conditions.
Conclusions:
- Intact resectoscopes and electrodes can cause thermal injury via capacitive coupling during prolonged procedures.
- Defective electrode insulation leads to significant stray currents, causing extensive tissue burns through direct contact with the sheath.