Active electrode monitoring. How to prevent unintentional thermal injury associated with monopolar electrosurgery at laparoscopy

BACKGROUND: In recent years, the use of minimally invasive surgery (MIS) has expanded to a wide variety of surgical specialties. The increased popularity of the procedure, however, has been accompanied by its share of complications, including trocar lacerations and inadvertent thermal injuries to nontargeted tissues during monopolar electrosurgery. METHODS: A survey on electrosurgical thermal injuries and three case studies are presented. The new technology of active electrode monitoring (AEM) is described. RESULTS: AEM eliminates stray currents generated by insulation failure and capacitive coupling. CONCLUSIONS: To reduce the incidence of injury by monopolar electrosurgery at laparoscopy, there is a need for advanced technology, such as AEM. In addition, laparoscopic surgeons should be encouraged to study the basic concepts of the biophysics of electrosurgery.