Energy Sources for Gynecologic Laparoscopic Surgery: A Review of the Literature

Law, Kenneth S. K., Abbott, Jason A. and Lyons, Stephen D. (2014) Energy Sources for Gynecologic Laparoscopic Surgery: A Review of the Literature. Obstetrical and Gynecological Survey, 69 12: 763-776. doi:10.1097/OGX.0000000000000130

Author Law, Kenneth S. K.
Abbott, Jason A.
Lyons, Stephen D.
Title Energy Sources for Gynecologic Laparoscopic Surgery: A Review of the Literature
Journal name Obstetrical and Gynecological Survey   Check publisher's open access policy
ISSN 0029-7828
Publication date 2014-12
Year available 2014
Sub-type Article (original research)
DOI 10.1097/OGX.0000000000000130
Open Access Status
Volume 69
Issue 12
Start page 763
End page 776
Total pages 14
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Collection year 2015
Language eng
Formatted abstract
Importance: A range of energy sources are used in gynecologic laparoscopy. These energy sources include monopolar electrosurgery, bipolar electrosurgery (including “advanced bipolar” devices that incorporate tissue feedback monitoring), and various types of laser and ultrasonic technologies. Gynecologists using these tools should be aware of the potential benefits and potential dangers of these instruments.

Objective: This review provides an overview of the biophysics of these energy sources, their tissue effects, and the complications that may arise. It aims to highlight any potential advantages or disadvantages of various energy sources, as reported by clinical and laboratory studies.

Evidence Acquisition: Literature relating to energy sources used in gynecologic laparoscopy was reviewed.

Results: While laboratory-based studies have reported differences between various energy sources, these differences may not be clinically significant. The choice of instrumentation may depend on the nature of the surgical task being performed, but other factors, such as the surgeon’s training/experience, cost, and industry marketing, may also influence the decision.

Conclusions: An awareness of the pros and cons of each energy modality and their relative efficacy profiles is paramount.

Relevance: 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.

Target Audience: Obstetricians and gynecologists, family physicians

Learning Objectives: After completing this CME activity, physicians should be better able to analyze the principle biophysics of electrosurgery and its application to surgery, evaluate the types of injuries that can occur when using energy sources in gynecologic laparoscopy and how these injuries can be minimized, and compare the properties of different laparoscopic energy sources, highlighting the potential advantages and disadvantages of each device.
Keyword Ultrasonic Coagulating Shears
Vessel Sealing System
Large Sized Arteries
Bipolar Electrosurgery
Porcine Model
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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