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      Dual-sided electrosurgery handpiece for simultaneous tissue cutting and coagulation: first report on a conceptual design validated by an animal experiment

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          Abstract

          Objective

          To introduce and evaluate the safety of a novel dual-sided electrosurgery handpiece design for simultaneous tissue cutting and coagulation.

          Methods

          We designed a prototype double-sided handpiece allowing automatic switching between two electrodes with a simple handpiece flip. The concept of the system as a surgical instrument was assessed by an animal experiment.

          Results

          The skin of 15 Wistar albino white rats could be successfully incised and coagulated using both ends of the handpiece, thereby confirming the prospects and clinical applications of the system.

          Conclusion

          The dual-sided electrosurgery handpiece is a simple and safe alternative to the traditional electrosurgery pencil, allowing the simultaneous use of two electrodes without the hassle of frequent electrode replacement.

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          Most cited references17

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          Electrosurgery: history, principles, and current and future uses.

          Douglas P. Slakey, Nader N Massarweh, N Cosgriff (2006)
          Article 0 comments Cited 59 times – based on 0 reviews     Review now
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            Complications and recommended practices for electrosurgery in laparoscopy.

            Calvin R Chen, Katharine E. Yen, Jennifer Wu … (1999)
            Electrosurgery is one of the most commonly used energy systems in laparoscopic surgery. Two major categories of potential complications related to electrosurgery in laparoscopy are mechanical trauma and electrothermal injury. The latter can result from unrecognized energy transfer in the operational field or, less commonly, to unnoticed stray current outside the laparoscopic field of view. Stray current can result from insulation failure, direct coupling, or capacitive coupling. We reviewed the literature concerning essential biophysics of electrosurgery, including electrosurgical waveform differentiation, tissue effect, and variables that determine tissue effect. The incidence of electrosurgical injuries and possible mechanisms responsible for the injuries are discussed. Different types of injuries may result in different clinical manifestations and histopathological findings. Gross and microscopic pathological check-ups of the injury sites may distinguish between different mechanisms, and thus provide further clues postoperatively. Several recommended practices are proposed to avoid electrosurgical injury laparoscopically. To achieve electrosurgical safety and to prevent electrosurgical injuries, the surgical team should have a good understanding of the biophysics of electrosurgery, the basis of equipment and general tissue effects, as well as the surgeon's spatial orientation and hand-eye coordination. Some intraoperative adjuvant procedures and newly developed safety devices have become available may aid to improve electrosurgical safety. Knowledge of the biophysics of electrosurgery and the mechanisms of electrosurgical injury is important in recognizing potential complications of electrosurgery in laparoscopy. Procedures for prevention, intraoperative adjuvant maneuvers, early recognition of the injury with in-time salvage treatment, and alertness to postoperative warning signs can help reduce such complications.
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              Cause and prevention of electrosurgical injuries in laparoscopy.

              A. Darzi, J. P. Monson, C Nduka … (1994)
              Electrosurgical injuries occur during laparoscopic operations and are potentially serious. The overall incidence of recognized injuries is between one and two patients per 1,000 operations. The majority go unrecognized at the time of the electrical insult and commonly present three to seven days afterward with fever and pain in the abdomen. Since these injuries appear late the pathophysiology remains speculative. This article reviewed the physics of electrosurgery and provides the surgeon with an insight to the mechanisms responsible in each type of injury. In addition, a comprehensive search of the world literature has reviewed all articles on the topic. The main causes of electrosurgical injuries are: inadvertent touching or grasping of tissue during current application, direct coupling between a portion of intestine and a metal probe that is touching the activated probe, insulation breaks in the electrodes, direct sparking to the intestine from the diathermy probe, and current passage to the intestine from recently coagulated, electrically isolated tissue. The majority of injuries, not surprisingly, are caused by monopolar diathermy. Bipolar diathermy is safer and should be used in preference to monopolar diathermy, especially in anatomically crowded areas. An awareness of the hazards of diathermy together with an understanding of the mechanisms of injury should enable the surgeon to dissect tissue and to achieve hemostasis, while at the same time decreasing the risk of serious complications to the patient.
              Article 0 comments Cited 21 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med Devices (Auckl)
                Journal ID (iso-abbrev): Med Devices (Auckl)
                Journal ID (publisher-id): Medical Devices: Evidence and Research
                Title: Medical Devices (Auckland, N.Z.)
                Publisher: Dove Medical Press
                ISSN (Electronic): 1179-1470
                Publication date Collection: 2015
                Publication date (Electronic): 13 August 2015
                Volume: 8
                Pages: 351-357
                Affiliations
                [1 ]Department of Ophthalmology, Oculoplastics Service, Ain Shams University, Cairo, Egypt
                [2 ]Faculty of Medicine, Ain Shams University, Cairo, Egypt
                [3 ]Eye Subspecialty Centre, Cairo, Egypt
                Author notes
                Correspondence: Hatem A Tawfik, Department of Ophthalmology, Oculoplastics Service, Ain Shams University, 5 Ibn Elnafis Street, Off Makram Ebeid Street Nasr City, Cairo, Egypt, Tel +20 101 022 513, Fax +20 2 274 9374, Email hatem35@ 123456gmail.com
                Article
                Publisher ID: mder-8-351
                DOI: 10.2147/MDER.S85262
                PMC ID: 4540138
                SO-VID: 7fc44f79-aecb-423a-be28-58f85700351b
                Copyright © © 2015 Tawfik et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License
                License:

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Biotechnology
                Keywords: radiosurgery,ablative surgery,laser resurfacing,electrocautery,electrosurgery
                Data availability:
                ScienceOpen disciplines: Biotechnology
                Keywords: radiosurgery, ablative surgery, laser resurfacing, electrocautery, electrosurgery

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