Surgeon-controlled factors that reduce monopolar electrosurgery capacitive coupling during laparoscopy

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Electrosurgery Safety

Background:

• Monopolar electrosurgery is widely used in laparoscopy.
• Capacitive coupling is a potential source of unintended energy delivery.
• Understanding modifiable factors is crucial for patient safety.

Purpose of the Study:

• To identify surgeon-controlled factors influencing capacitive coupling during laparoscopic monopolar electrosurgery.
• To quantify capacitive coupling energy across various generator power settings, electrosurgical modes, and activation techniques.

Main Methods:

• Ex vivo analysis of laparoscopic monopolar electrosurgery.
• Measurement of cumulative capacitive coupling energy (Joules) using an oscilloscope.
• Systematic variation of power settings, cut vs. coagulation modes, and desiccation vs. fulguration vs. open air activation techniques.

Main Results:

• Increased power settings significantly elevated capacitive coupling energy (e.g., 50W vs. 25W).
• Coagulation mode generated higher capacitive coupling energy compared to cut mode.
• Open air activation and fulguration techniques resulted in substantially greater capacitive coupling energy than desiccation.

Conclusions:

• Lowering generator power settings can reduce capacitive coupling.
• Utilizing the cut mode over coagulation mode minimizes capacitive coupling.
• Employing the desiccation technique is preferable to open air activation or fulguration for reducing capacitive coupling.