title: Use of the electrosurgical unit in a carbon dioxide atmosphere.
abstract: The electrosurgical unit (ESU) utilizes an electrical discharge to cut and coagulate tissue and is often held above the surgical site, causing a spark to form. The voltage at which the spark is created, termed the breakdown voltage, is governed by the surrounding gaseous environment. Surgeons are now utilizing the ESU laparoscopically with carbon dioxide insufflation, potentially altering ESU operating characteristics. This study examines the clinical implications of altering gas composition by measuring the spark gap distance as a marker of breakdown voltage and use of the ESU on a biologic model, both in room air and carbon dioxide. Paschen's Law predicted a 35% decrease in gap distance in carbon dioxide, while testing revealed an average drop of 37-47% as compared to air. However, surgical model testing revealed no perceivable clinical difference. Electrosurgery can be performed in carbon dioxide environments, although surgeons should be aware of potentially altered ESU performance.
authors.affiliation: a Department of Anesthesiology , Scott & White Hospital, The Texas A&M University System Health Science Center College of Medicine , Temple , TX , USA ;
authors.forename: William C
authors.initials: WC
authors.lastname: Culp
authors.affiliation: a Department of Anesthesiology , Scott & White Hospital, The Texas A&M University System Health Science Center College of Medicine , Temple , TX , USA ;
authors.forename: Bradly A
authors.initials: BA
authors.lastname: Kimbrough
authors.affiliation: a Department of Anesthesiology , Scott & White Hospital, The Texas A&M University System Health Science Center College of Medicine , Temple , TX , USA ;
authors.forename: Sarah
authors.initials: S
authors.lastname: Luna
authors.affiliation: a Department of Anesthesiology , Scott & White Hospital, The Texas A&M University System Health Science Center College of Medicine , Temple , TX , USA ;
authors.forename: Aris J
authors.initials: AJ
authors.lastname: Maguddayao
authors.affiliation: b Department of Surgery , Scott & White Hospital, The Texas A&M University System Health Science Center College of Medicine , Temple , TX , USA.
authors.forename: Jack L
authors.initials: JL
authors.lastname: Eidson
authors.affiliation: a Department of Anesthesiology , Scott & White Hospital, The Texas A&M University System Health Science Center College of Medicine , Temple , TX , USA ;
authors.forename: David V
authors.initials: DV
authors.lastname: Paolino
mesh_terms: D000388:Air; D000818:Animals; D002245:Carbon Dioxide; D002417:Cattle; D003300:Copper; D004598:Electrosurgery; D004777:Environment; D005528:Foot / Q000601:surgery; D009873:Operating Rooms; D000069466:Red Meat
chemical_list: D002245:Carbon Dioxide; D003300:Copper
keywords: Electrosurgical unit; Paschen’s Law; breakdown voltage; carbon dioxide