Numerical and experimental assessment of implant-induced thermal risks during electrosurgical procedures

This study investigates the thermal risks associated with electrosurgical units (ESUs) in patients with metallic orthopedic implants. Using a combination of phantom-based experiments and computational simulations, we evaluated the effects of implant presence and electrode configuration on localized heating. Gel phantom experiments were conducted under three conditions: without implants, with a titanium rod, and with a metallic plate positioned between ESU electrodes. Voltage and temperature changes were recorded across ESU power settings at 20 W, 30 W, and 40 W. These results were validated using COMSOL simulations. To assess clinical relevance, human body simulations with the Duke model in Sim4Life were performed at 40 W, 80 W, and 120 W, evaluating the impact of implant proximity and dispersive electrode placement. Results showed strong agreement between experimental and simulation data. Significant temperature increases were observed near implants, especially at higher power settings or with short distance between implant and ESU electrode, the maximum temperature increase could achieve 11.6 °C at the implant device when the device is 3 cm away from active electrode. This is about 4 times higher than that from the scenario without any implants. ESU electrode placement can also influence heating patterns. These findings highlight the importance of surgical configuration and implant positioning in minimizing thermal risks during electrosurgical procedures.