Surgeon-controlled factors that reduce monopolar electrosurgery capacitive coupling during laparoscopy.
OBJECTIVE
To determine the factors that can be modified by the surgeon to reduce monopolar electrosurgery capacitive coupling during laparoscopy. Specific aims were to determine the capacitive coupling energy using different generator power settings, mode settings (cut vs. coagulation), and surgical techniques (desiccation vs. fulguration vs. open air activation).


METHODS
An oscilloscope determined the cumulative energy (Joules) of capacitive coupling occurring using laparoscopic monopolar electrosurgery ex vivo.


RESULTS
Higher power settings increased capacitive coupling energy (Joules): 25 Watts (1.1±0.7) versus 50 Watts (2.4±0.5; P<0.05). Coagulation mode created greater capacitive coupling energy (2.2±1.0) in comparison with cut mode (1.1±0.5; P<0.05). Open air activation (3.3±0.6) and fulguration (3.3±1.0) had higher capacitive coupling energy in comparison with desiccation (0.6±0.2; P<0.05).


CONCLUSIONS
Surgeons can minimize capacitive coupling energy during laparoscopy by lowering the power setting, using cut mode (instead of coagulation), and using the surgical technique of desiccation (instead of open air activation or fulguration).
Department of Surgery, University of Colorado Denver School of Medicine, Aurora, CO, USA. thomas.robinson@ucdenver.edu
Thomas N
TN
Robinson
Katherine R
KR
Pavlovsky
Heidi
H
Looney
Greg V
GV
Stiegmann
Francis T
FT
McGreevy
D025802:Electric Capacitance / Q000009:adverse effects; D004598:Electrosurgery / Q000009:adverse effects / Q000379:methods*; D066298:In Vitro Techniques; D010535:Laparoscopy / Q000379:methods*