Insulation failure in electrosurgery instrumentation: a prospective evaluation

Abstract

Accidental burns are a hidden problem and can lead to patient complications. In Central Sterilization Service Department, prevention currently includes only visual control of electrosurgery instrumentation, but testing campaigns are now necessary in order to identify maximum instruments' defects.

Complications in laparoscopic and robotic-assisted surgery: definitions, classifications, incidence and risk factors - an up-to-date review.

“…The bipolar cable and forceps account for 31–42% of instrument malfunctions [ 152 , 160 ]. Insulation failure (IF) affects 19–37% of ESDs, reaching 39% in monopolar instruments [ 161 , 162 ]. IF is localized in 40–54% of cases at the distal third of the instrument and is more frequent in reusable instruments [ 154 , 162 ].…”

“…Insulation failure (IF) affects 19–37% of ESDs, reaching 39% in monopolar instruments [ 161 , 162 ]. IF is localized in 40–54% of cases at the distal third of the instrument and is more frequent in reusable instruments [ 154 , 162 ]. Intense exploitation of reusable instruments, predominant use of high voltage modes, multiple passages through trocars and frequent mechanized sterilization facilitate the development of IF [ 154 ].…”

“…Especially the safety of laparoscopic entry and that of ESD use could be reduced through the sufficient knowledge of anatomy and surgical instruments and adherence to basic laparoscopic principles [ 146 , 204 ]. Given that these two areas are responsible for the vast majority of complications and catastrophes, it is confusing why some surgeons simply ignore these facts [ 3 , 9 , 151 , 162 , 163 , 204 ]. Nevertheless, several ways to improve patients’ security and surgical proficiency have been noted during the last two decades, especially multi-level certifications programs offered by national and international societies [ 45 , 46 ] as well as modern, scientifically sound concepts of laparoscopic training.…”

Is electrosurgery a revolution? Mechanism, benefits, complications, precautions

“…The current flows from the shaft of the laparoscopic instruments to the tip. There might be insulation failures in the shaft of these instruments [52]. In this instance, the current could pass from the shaft to the intraabdominal organs.…”

“…If reusable or disposable instruments are used by sterilizing repeatedly, the probability of injury to the abdominal organs increases. Reusable instruments should be checked before use, and disposable instruments should not be reused [52,53].…”