Energy Sources for Gynecologic Laparoscopic Surgery

Abstract

It is important that surgeons have an understanding of the biophysics of these technologies in order to understand their limitations and potential dangers and to utilize the most appropriate energy source(s) in the appropriate clinical setting, in order to both minimize the risk of inadvertent injuries during gynecologic laparoscopy and to maximize cost-efficient delivery of health care.

Perspective of Electrosurgical Sources in Minimal Access Surgery

“…Smoke production during monopolar electrosurgery may be problematic, especially during fulguration. 3 There is a risk of capacitative coupling if by mistake the wire gets wrapped around other instrument. So, monopolar electrosurgery is a relatively inexpensive, readily available, and versatile energy source that yields the best range of tissue effects, but despite all this it has a large risk of complications leading to smaller safety margin.…”

“…2 These tissue impacts are fundamentally accomplished by using the "cut" or "coag" mode of electrosurgical unit (ESU) while contacting or non contacting the objective tissue (Table 2). 3 Varying other parameters are under the specialist's control, such as power setting, length of enactment, and terminal arrangement, can facilitate adjusting the wanted tissue effect. [1][2][3] All energy sources generate tissue temperatures above 45°C, the temperature at which irreversible cell damage occurs.…”

“…3 Varying other parameters are under the specialist's control, such as power setting, length of enactment, and terminal arrangement, can facilitate adjusting the wanted tissue effect. [1][2][3] All energy sources generate tissue temperatures above 45°C, the temperature at which irreversible cell damage occurs. Monopolar electrosurgery generates tissue temperatures of ~100°C, 100-200°C, and >200°C for desiccation, vaporization, and fulguration respectively.…”

“…More as of late the new up-to-date model have been specifically produced for larger vessel fixing and cutting, this gadget has been evaluated by the FDA to seal vessels up to 7 mm in diameter. 3 These tissue impacts are accomplished without the passage of electric current through the patient or the tissue held by the device. Points of interest of ultrasonic devices incorporate less instrument movement, inferable from the blend of vessel-fixing and tissue cutting, and less smoke.…”

Supercontinuum source in the investigation of laser-tissue interactions: “ex vivo” study

“…Later on, medical laser applications increased more and more, including surgery, gynaecology, dentistry and neurology [2][3][4]. Then with the introduction of PDT (Photodynamic Therapy) and LLLT (Low Level Laser Therapy) in medicine, new therapeutic possibilities were offered to clinicians [5,6].…”