Physico-Chemical Approaches to Improve the Characteristics of Electrosurgical Instruments

Abstract

This article is devoted to an overview of approaches to improving the characteristics of electrosurgical instruments. Currently, in minimally invasive surgery, the main material of an electrosurgical instrument is usually stainless steel. However, during operation, tissue sticking and carbonization occur, as well as corrosion of the instrument, which leads to a decrease in efficiency and adverse events. In this regard, it is very promising to develop new physicochemical approaches to improve the characteristics of electrosurgical instruments in order to avoid disadvantages noted above. On the one hand, it is proposed to replace stainless steel with other electrically conductive materials (gold, tungsten, zirconium dioxide, etc.). On the other hand, options for developing functional coatings of stainless steel (metallic, polymeric and composite) are considered. Among the "classical" approaches, one can distinguish coatings with gold, as well as nitrides and oxides of refractory metals (Cr, Zr, Ti), which are characterized by higher thermal conductivity and a pronounced anti-sticking effect. Very promising is the use of coatings based on diamond-like carbon, which have a higher contact angle compared to stainless steel (97.25±1.87° versus 75.47±2.55°) with a higher microhardness of the coating (2250 Hv versus 500 Hv). Particular attention is drawn to superhydrophobic coatings, for example, a coating based on hexamethyldisilazane with SiO2 nanoparticles, the contact angle of which is two times higher than stainless steel (153.4±2.6° versus 73.1±0.6°). An alternative to coatings is the formation of microchannels and nanoroughness on the surface of electrosurgical instruments in order to reduce tissue adhesion and the risk of carbonization. Implementation of the principles of biomimicry, i.e. imitation of the structures of wildlife, has led to research in the field of creating analogues of microstructures (pangolin scales, shark skin), as well as liquid-infused surfaces, imitating the properties of the leaves of the carnivorous Nepenthes pitcher plant, which, due to the lubricant layer on their surface, have lower adhesive properties compared to unmodified material. Thus, the problem of modifying the surface of electrosurgical instruments has already been approached from several angles, and it can be stated with a sufficient degree of confidence that the number of studies in this direction will only increase.