Gynecologic and dermatologic electrosurgical units: a comparative review

Area of Science:

• Surgical Technology
• Biomedical Engineering

Background:

• Electrosurgery is a widely used surgical method for tissue excision and hemostasis.
• Electrosurgical units (ESUs) utilize high-frequency, low-voltage electrical energy.
• Critical evaluation of ESUs is essential for ensuring patient safety and optimal surgical outcomes.

Purpose of the Study:

• To critically evaluate electrosurgical units (ESUs) based on safety, electrical specifications, design, and performance.
• To compare the characteristics of 13 ESUs from 11 different manufacturers.
• To identify exemplary ESUs for specific surgical applications, particularly in gynecology and dermatology.

Main Methods:

• Quantitative electrical specifications and histologic thermal artifact measurements were recorded.
• Qualitative observations of ESU performance were documented.
• 13 electrosurgical units representing 11 manufacturers were included in the evaluation.

Main Results:

• The Aspen Sabre 180 and Laserscope e10 were identified as exemplary based on safety criteria.
• Minimal cut-mode thermal artifact (<10 microns) was observed with the Cooper Leep 6000, Laserscope e10, and Utah Finesse.
• The Gyne-Tech Autolepe 2000 and 4000, Laserscope e10, and Elmed ESU 30 demonstrated a significant fulguration distance (>0.5 mm).

Conclusions:

• The Aspen Sabre 180 and Laserscope e10 are highly recommended for gynecologic electrosurgery.
• The Utah Finesse, Finesse II, and Gyne-Tech Autolepe 4000 also show promise for gynecologic applications.
• Many evaluated ESUs are suitable for dermatologic electrosurgery, with specific exceptions noted.