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Patient Safety During Laparoscopic Electrosurgery

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Electroshield® Active Electrode Monitoring System

Laparoscopic Electrosurgery

Monopolar laparoscopic electrosurgery involves the insertion of optical and surgical instruments into the abdomen through small incisions, providing the surgeon access to the peritoneal cavity and a view of the surgical site. Due to a limited field of vision during minimally invasive surgery, surgeons can see only approximately 10% of the live electrode (the area inside the square), thus any burns outside the surgeon's field of view can go undetected until days after surgery by which time serious burns may have caused severe infection.

Insulation Failure During Laparoscopic Electrosurgery

The shaft of the active electrode is covered by a layer of insulation designed to protect against the release of stray energy. However, the insulation can break down over time, during a single laparoscopic procedure, or during disinfection and sterilization procedures. Defects in the electrode's insulation outside the surgeon's limited field of view (the area outside the square) can allow stray electrical energy to burn non-targeted tissue.

Capacitive Coupling During Laparoscopic Electrosurgery

Capacitive coupling can occur outside the surgeon's limited field of view (the area outside the square) despite intact insulation around the shaft of the electrode. The rapidly varying electrical field around the active electrode is unimpeded by electrical insulation and creates electrical currents by alternately attracting and repelling ions in surrounding conductors, such as metal instruments and body tissue. The movement of electrically charged ions in capacitively coupled tissue may cause currents that can heat tissue sufficiently to burn it. Currents may also arc from capacitively coupled instruments (such as the trocar cannula) to tissue, causing burns.

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