Laparoscopic electrosurgery: complications and prevention

Even though monopolar electrosurgery has been utilized laparoscopically for over two decades, post procedural complications, including bowel burns, remain significant. Initially employed by gynecologists, electrosurgical cutting and coagulation is rapidly becoming popular with general surgeons and urologists. Electrosurgery in a closed environment presents a special set of problems and in order to prevent complications surgeons need to familiarize themselves with the basic science of electrosurgery and the potential laparoscopic complications. This chapter presents an overview of the physics of electrosurgery with special attention to laparoscopic use. Also discussed are two technologies, a shielding-monitoring system for monopolar electrodes and bipolar electrodes, which minimize and/or eliminate potential laparoscopic complications associated with the use of electrosurgery.