Safe use of electrosurgery in gynaecological laparoscopic surgery

Abstract

Key content: It is crucial to understand the basics of electrosurgery to deliver safe and effective laparoscopic surgery.Electrosurgical tissue effects include vaporisation, desiccation and coagulation, which help to achieve cutting, dissection, ablation and haemostasis during surgery.Electrosurgery is delivered through monopolar and bipolar instruments.Surgeons can avoid complications of electrosurgery by understanding the mechanisms underlying them.Establishment of a formal training programme in surgical energy is needed for surgeons and theatre staff to provide safe laparoscopic surgery. Learning objectives: To understand the applied physics of electrosurgery.To describe the various electrosurgical tissue effects and the variables controlling them.To identify the differences between monopolar and bipolar instruments.To know the mechanisms of various electrosurgical complications and safety measures to avoid them. Ethical issues: Is it ethical to use energy devices in laparoscopic surgery with little or no formal training about their appropriate use and safety?Do surgeons need to know about all energy devices they use in operating theatres?Should all allied healthcare professionals working in operating theatres undergo formal training on the use of electrosurgery?