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Capacitive coupled stray currents during laparoscopic and endoscopic electrosurgical procedures.
R D Tucker1, C R Voyles, S E Silvis
1Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Biomedical Instrumentation & Technology
|July 1, 1992
Summary
Capacitive coupling in electrosurgery can transfer dangerous power levels to unintended surgical tools. This can lead to serious patient injury, but methods exist to minimize this risk during laparoscopic and endoscopic procedures.
Area of Science:
- Medical Devices
- Surgical Technology
- Electrosurgery
Background:
- Capacitively coupled currents are often overlooked in laparoscopic and endoscopic radiofrequency electrosurgery.
- These currents can pose significant risks during minimally invasive procedures.
Purpose of the Study:
- To document and quantify capacitive current coupling during laparoscopic and endoscopic electrosurgery.
- To identify potential patient complications arising from this phenomenon.
- To discuss methods for minimizing capacitive coupling.
Main Methods:
- Quantification of current coupling into metal trocar cannulas (laparoscopic surgery).
- Quantification of current coupling into guide wires (endoscopic surgery).
- Analysis of power transfer to nearby metal conductors and potential dissipation into patient organs.
Main Results:
- Capacitive coupling can deliver over 25 watts (laparoscopic) and 15 watts (endoscopic) to unintended conductors.
- This energy can be dissipated into critical organs like the bowel or common bile duct.
- Capacitive coupling is a contributing factor to serious patient complications.
Conclusions:
- Minimizing capacitive coupling is crucial for patient safety in electrosurgery.
- Strategies such as active electrode shielding, dispersive metal cannulas, sheathed guide wires, and bipolar active electrodes can mitigate risks.