MegaDyne Mega 2000 return electrode

The Mega 2000 return electrode, manufactured by MegaDyne Medical Products, is a reusable, capacitively coupled return electrode used in monopolar electrosurgery. It consists of a large--almost two feet by three feet--sheet of flexible conductive fabric that is enclosed in a nonlatex, urethane insulating material. Unlike conductive return electrodes, which are applied adhesively to the patient, the Mega 2000 does not come into direct contact with the patient. Rather, it is placed on an OR table and covered by a protective sheath and, at most, a cover sheet and draw sheet. The patient lies on top of these sheets. The electrode forms a large capacitor with the patient, capacitively coupling the patient into the electrosurgical circuit. Because it is reusable--only the protective sheath is replaced--the Mega 2000 is touted as being a significantly less expensive alternative to traditional conductive return electrodes. And because it is not affixed to the patient, it offers potential advantages for patients having frail skin or extensive skin and tissue damage that would make the use of adhesive return electrodes difficult or impossible. While some healthcare facilities have considered using this return electrode because of its potential clinical and economic benefits, others have questioned its safety because it differs in design from a traditional return electrode. Therefore, we have examined its safety, efficacy, and cost-effectiveness in this Evaluation. We also offer guidance for facilities trying to decide whether to buy the Mega 2000.