electro surgical units

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Diathermy UnitsA Saudi Food & Drug

Administration Program

Senior Project Engineer

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Diatherm Units

Electrosurgical Burns

Laparoscopic Accidents

n ur es to e ca ta

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Some Basic Electrosurgery Facts

Used in about 80% of all surgical

Ver effective sur ical tool Cutting

Fulguration

Not well understood by clinicians

problem reporting databases

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Basic Princi les of Electrosur er

Current conducted through a complete circuit including

the generator, insulated cables, electrodes, and the patient

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Mono olar Electrosur er

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ec rosurg ca

Unit

Tissue between

Current

Flowtips of forceps

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ec rosurgery a e y ea ures

Verifies that a return electrode is

Cannot detect if return electrode is

the patient

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Electrosurgery Safety Features

Return Electrode Contact Quality Monitor

continuity monitor

the dispersive electrode and patient

ECRI stron l recommends usinelectrosurgical units with RECQM

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Interrogation current flowse ween eac p a e o e

electrode and the patient.

one s e s par a ydetached from the patient,

an a arm w soun .

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Fires, Explosions Prepping Solutions, Surgical Drapes,

Bowel Gas

Oxygen-Enriched Atmosphere

Too Much/Too Little Power Delivered Organ Perforations

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Electrosurgical Accidents

Argon Beam Coagulators

Interference (EMI)

ESU as Source of EMI

Hand sensation

Alternate pathways

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Electrosurgical Injuries

Return Electrode Issues oor e ec ro e p acemen Lack of skin prep

omp e e or par a remova o re urnelectrodes

Edge effects

activation times

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ec rosurg ca n ur es

Insulation surrounding conductive shaft Breakdown

Repeated Sterilization

Cuts, Nicks, Abrasions

Capacitive Coupling

other instruments or tissues

Inadvertent activation!

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Active Electrode

Alternate Site Burns (Use a Holster!)

Laparoscopic Active Electrodes La arosco ic Cannula Burns

Failure to Use Activation Tone

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Inadvertent activation of the ESU due to

unintentional switch activation

User places active electrode on the patient or thesurg ca rape e ween n en e ac va ons

Safety holster not used

Insulation failure along shaft during,

burn to tissue inside mouth or to lip

tissue

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Poor Site Preparation Poor Application

technique

Non-uniformConductivity

Repositioning

Electrode

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Burns

Use of electrolytic (conductive) distention/irrigation

media during TURP Conductive solution may render electrosurgery less

effective

Lower surgical effect may lead user to increase

Conductive solution lowers impedance at active

electrode, elevating current Increased power and lower impedance increases

current through dispersive return electrode

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Laparoscopic Electrosurgery

Monopolar vs. Bipolar Current leakage though cannula

Insulation breaka e

Fire

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aparoscop c n ur es

Insulation failures Capacitive coupling

Device interference

Resulting in bowel perforations,

excess bleeding, damage to nontargettissue, etc.

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Heat, sparks, flaming gases

Rarel a device failure aknown complication

21Copyright 2007

electro surgical units

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