Principles and safe use of electrosurgery in minimally invasive surgery
Mohsen El‐Sayed, Ertan Sarıdoğan
Abstract
Abstract: Electrosurgery is the most commonly used form of surgical energy in both open and minimally invasive surgery. Advanced electrosurgical devices have revolutionised laparoscopic surgery with increasing uptake of more complex procedures. Although electrosurgical devices are ubiquitous in the operating rooms, evidence around the globe showed that surgeons of different grades and specialties have significant gaps in their knowledge of electrosurgery which can lead to serious complications. Some inherent flaws in electrosurgery partly contributed to such complications. Consequently, the industry developed technologies to address these flaws and minimise complications. On the other hand, the profession is calling for formal training and assessment of all staff involved in the use of surgical energy. The aim of this review is to bridge such knowledge gaps by addressing the basic principles of electrosurgery as well as the mechanisms of its complications. It covers monopolar, bipolar and advanced bipolar electrosurgery along with their advantages and disadvantages. In addition, it highlights the good practice in electrosurgery and how to avoid complications. Recent technological developments in electrosurgery are addressed along with their impact on patient safety. All in all, such knowledge would help surgeons master the use of various electrosurgical devices to achieve the intended effects and minimise risk to patients.