Electrosurgery: short-circuit between education and practice

Meeuwsen, F.C.; Klein, Jan; Elst, Maarten van der; Dankelman, Jenny; Dobbelsteen, John J. van den

doi:10.1080/13645706.2018.1513945

Cited by 15 publications

(8 citation statements)

References 14 publications

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“…Despite the fact that electrosurgery has been commonplace for the past century, transatlantic evidence shows that many surgeons of different specialties and grades poorly understand electrosurgery. 3,[44][45][46] This knowledge gap may negatively affect patient outcomes and safety. As a response to this safety concern, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) developed the FUSE (Fundamental Use of Surgical Energy) programme.…”

Section: Training Programmementioning

confidence: 99%

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Safe use of electrosurgery in gynaecological laparoscopic surgery

El-Sayed

Mohamed

Sarıdoğan

2019

The Obstetric & Gynaecologis

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It is crucial to understand the basics of electrosurgery to deliver safe and effective laparoscopic surgery. Electrosurgical tissue effects include vaporisation, desiccation and coagulation, which help to achieve cutting, dissection, ablation and haemostasis during surgery. Electrosurgery is delivered through monopolar and bipolar instruments. Surgeons can avoid complications of electrosurgery by understanding the mechanisms underlying them. Establishment of a formal training programme in surgical energy is needed for surgeons and theatre staff to provide safe laparoscopic surgery. Learning objectivesTo understand the applied physics of electrosurgery.To describe the various electrosurgical tissue effects and the variables controlling them. To identify the differences between monopolar and bipolar instruments. To know the mechanisms of various electrosurgical complications and safety measures to avoid them. Ethical issuesIs it ethical to use energy devices in laparoscopic surgery with little or no formal training about their appropriate use and safety? Do surgeons need to know about all energy devices they use in operating theatres? Should all allied healthcare professionals working in operating theatres undergo formal training on the use of electrosurgery?

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Section: Training Programmementioning

confidence: 99%

“…In response, the profession is calling for formal training programmes in the safe use of surgical energy for all staff required to use it. 3 Additionally, the industry is addressing design flaws in electrosurgery to provide safer devices. 2 (>100 kHz) that passed through the human body without neuromuscular stimulation or electric shock.…”

Section: Introductionmentioning

confidence: 99%

Safe use of electrosurgery in gynaecological laparoscopic surgery

El-Sayed

Mohamed

Sarıdoğan

2019

The Obstetric & Gynaecologis

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“…Electrosurgery (ES ) is used in over 80% of surgical operations (1), among which high-frequency electrotome (conventional ES) is currently the most widely used electrosurgical device (2). ES applies radiofrequency (RF) alternating current to generate heat at the cutting blade tip and tissue interface, allowing surgeons to effectively cut tissue and achieve rapid hemostasis simultaneously, resulting Original Article in a shortened operation time and improved operational efficiency.…”

Section: Introductionmentioning

confidence: 99%

Comparative healing of swine skin following incisions with different surgical devices

et al. 2021

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Background: Electrosurgical technology is widely used in surgical dissection and hemostasis, but the generated heat creates thermal injury to adjacent tissues and delays wound healing. The plasma blade (PB) applies pulsed radiofrequency (RF) to generate electrical plasma along the edge of a thin, flat, insulated electrode, minimizing collateral tissue damage. This study aimed to evaluate wound healing in swine skin following incision with a new surgical system that applies low-temperature plasma (NTS-100), a foreign PB, conventional electrosurgery (ES), and a scalpel blade.Methods: In vitro porcine skin and an in vivo porcine skin model were used in this study. Full-thickness skin incisions 3 cm in length were made on the dorsum of each animal for each of the 5 surgical procedures at 0, 21, 28, 35, and 42 days. The timing of the surgical procedures allowed for wound-healing data points at 1, 2, 3, and 6 weeks accordingly. Local operating temperature and blood loss were quantified. Wounds were harvested at designated time points, tested for wound tensile strength, and examined histologically for scar formation and tissue damage. Results: Local operating temperature was reduced significantly with NTS-100 (cut mode 83.12±23.55 ℃; coagulation mode 90.07±10.6 ℃) compared with PB (cut mode 94.46±11.48 ℃; coagulation mode 100.23±6.58 ℃, P<0.05) and ES (cut mode 208.99±34.33 ℃, P<0.01; coagulation mode 233.37±28.69 ℃, P<0.01) in vitro. Acute thermal damage from NTS-100 was significantly less than ES incisions (cut mode: 247.345±42.274 versus 495.295±103.525 μm, P<0.01; coagulation mode: 351.419±127.948 versus 584.516±31.708 μm, P<0.05). Bleeding, histological scoring of injury, and wound strength were equivalent for the NTS-100 and PB incisions. Conclusions:The local operating temperature of NTS-100 was lower than PB, and NTS-100 had similarly reliable safety and efficacy.

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“…La electrocirugía permite a los cirujanos separar el tejido y lograr una hemostasia rápida. Sin embargo, las dificultades para predecir los efectos de las combinaciones de magnitud de corriente eléctrica, generación de calor y factores relacionados con el paciente pueden conducir a complicaciones graves (1) . Los estudios muestran que la electrocirugía puede causar daños al paciente, tales como quemaduras quirúrgicas, incendios en el quirófano, interferencia con marcapasos y lesiones intestinales (2)(3)(4) .…”

Section: Introductionunclassified

Avaliação de intervenções educativas e conhecimento da equipe de enfermagem no uso de eletrocirurgia

Almeida¹,

Menegüeti²,

Ferreira³

et al. 2021

Enf Global

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Objetivo: Evaluar el efecto de las intervenciones educativas en el conocimiento y la aplicabilidad de la electrocirugía del equipo de enfermería.Material y método: Cuasiexperimento, con evaluaciones antes y después en un solo grupo, llevado a cabo en el centro quirúrgico de un hospital universitario terciario brasileño. Se realizó en siete etapas, se aplicó un cuestionario semiestructurado para evaluar los conocimientos de los participantes. Los participantes fueron expuestos a dos intervenciones educativas (clase expositiva, dialogada y video clase) y después de cada intervención se evaluó la retención de conocimientos. También se evaluaron indicadores de la aplicación de la unidad de electrocirugía durante los procedimientos quirúrgicos.Resultados: Participaron del estudio 4 enfermeros y 28 técnicos en enfermería. Los enfermeros tenían conocimientos previos sobre el tema de la mayor parte de los tópicos. Los técnicos en enfermería, mejoraron en los ítems verificación del equipamiento y colocación de la placa. Conclusiones: Los profesionales presentaron un buen desempeño teórico pero el mismo no se refleja en la práctica porque los profesionales son reacios a realizar prácticas que no coincidan con la teoría. La realización de este tipo de investigaciones es conveniente porque les permite a los gestores la posibilidad de proponer proyectos para una mejora continua de la asistencia perioperatoria. Objective: To evaluate the effect of educational interventions on the Nursing team's knowledge and applicability of electrosurgery.Material and Method: A quasi-experiment, with pre- and post-tests in a single group developed in the operating room of a Brazilian tertiary-level university hospital. It was developed in seven stages, with the application of a semi-structured questionnaire to assess the participants' knowledge. The participants were exposed to two educational interventions (lecture, dialogue and video-lesson) and, after each intervention, they were evaluated for knowledge retention. Indicators of the application of the electrosurgery unit during surgical procedures were also evaluated.Results: Four nurses and 28 nursing technicians participated in the study. The nurses had prior knowledge of the theme on most of the topics. Among the nursing technicians, there was an improvement in the “equipment check” and “electrodispersive plate positioning” items. Conclusions: The professionals presented good theoretical performance but the same is not evidenced in the practice because they are reluctant to having a practice different from the theory. Research of this nature is timely because it provides managers with a possibility to propose projects for continuous improvement of perioperative assistance. Objetivo: Avaliar o efeito de intervenções educativas no conhecimento e aplicabilidade de eletrocirurgia da equipe de enfermagem. Material e Método: Quase-experimento, com pré e pós-testes em um único grupo desenvolvido no centro cirúrgico de um hospital universitário terciário brasileiro. Foi desenvolvido em sete etapas, com aplicação de questionário semi-estruturado para avaliação do conhecimento dos participantes. Os participantes foram expostos a duas intervenções educativas (aula expositiva, dialogada e vídeo aula) e após cada uma das intervenções, foram avaliados quanto a retenção do conhecimento. Também foram avaliados indicadores da aplicação da unidade de eletrocirurgia durante os procedimentos cirúrgicos. Resultados: Participaram do estudo quatro enfermeiros e 28 técnicos de enfermagem. Os enfermeiros apresentaram conhecimento prévio do tema na maioria dos tópicos. Entre os técnicos de enfermagem, observou-se melhora nos itens checagem do equipamento e posicionamento da placa eletrodispersiva. Conclusões: Os profissionais apresentaram um bom rendimento teórico, porém o mesmo não fica evidente na prática pois os profissionais relutam em ter uma prática diferente da teoria. Pesquisas dessa natureza são oportunas pois proporcionam aos gestores uma possibilidade de propor projetos de melhoria contínua da assistência perioperatória.

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Electrosurgery: short-circuit between education and practice

Cited by 15 publications

References 14 publications

Safe use of electrosurgery in gynaecological laparoscopic surgery

Safe use of electrosurgery in gynaecological laparoscopic surgery

Comparative healing of swine skin following incisions with different surgical devices

Avaliação de intervenções educativas e conhecimento da equipe de enfermagem no uso de eletrocirurgia

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