TY - JOUR
T1 - The art of electrosurgery
T2 - Trainees and experts
AU - Meeuwsen, Frédérique C.
AU - Guédon, Annetje C.P.
AU - Arkenbout, Ewout A.
AU - van der Elst, Maarten
AU - Dankelman, Jenny
AU - Van Den Dobbelsteen, John J.
PY - 2017
Y1 - 2017
N2 - The benefits of electrosurgery have been acknowledged since the early 1920s, and nowadays more than 80% of surgical procedures involve devices that apply energy to tissues. Despite its widespread use, it is currently unknown how the operator's choices with regard to instrument selection and application technique are related to complications. As such, the manner in which electrosurgery is applied can have a serious influence on the outcome of the procedure and the well-being of patients. The aim of this study is to investigate the variety of differences in usage of electrosurgical devices. Our approach is to measure these parameters to provide insight into application techniques. A sensor was developed that records the magnitude of electric current delivered to an electrosurgical device at a frequency of 10 Hz. The sensor is able to detect device activation times and a reliable estimate of the power-level settings. Data were recorded for 91 laparoscopic cholecystectomies performed by different surgeons and residents. Results of the current measurement data show differences in the way electrosurgery is applied by surgeons and residents during a laparoscopic cholecystectomy. Variations are seen in the number of activations, the activation time, and the approach for removal of the gallbladder. Analysis showed that experienced surgeons have a longer activation time than residents (3.01 vs 1.41 seconds, P <.001) and a lower number of activations (102 vs 123). This method offers the opportunity to relate application techniques to clinical outcome and to provide input for the development of a best practice model.
AB - The benefits of electrosurgery have been acknowledged since the early 1920s, and nowadays more than 80% of surgical procedures involve devices that apply energy to tissues. Despite its widespread use, it is currently unknown how the operator's choices with regard to instrument selection and application technique are related to complications. As such, the manner in which electrosurgery is applied can have a serious influence on the outcome of the procedure and the well-being of patients. The aim of this study is to investigate the variety of differences in usage of electrosurgical devices. Our approach is to measure these parameters to provide insight into application techniques. A sensor was developed that records the magnitude of electric current delivered to an electrosurgical device at a frequency of 10 Hz. The sensor is able to detect device activation times and a reliable estimate of the power-level settings. Data were recorded for 91 laparoscopic cholecystectomies performed by different surgeons and residents. Results of the current measurement data show differences in the way electrosurgery is applied by surgeons and residents during a laparoscopic cholecystectomy. Variations are seen in the number of activations, the activation time, and the approach for removal of the gallbladder. Analysis showed that experienced surgeons have a longer activation time than residents (3.01 vs 1.41 seconds, P <.001) and a lower number of activations (102 vs 123). This method offers the opportunity to relate application techniques to clinical outcome and to provide input for the development of a best practice model.
KW - best practice model
KW - electrosurgery
KW - medical technology
KW - patient safety
KW - surgical training
UR - http://resolver.tudelft.nl/uuid:c8078a53-a9e7-48a0-a8a4-ad54ef0c9fd0
UR - http://www.scopus.com/inward/record.url?scp=85023201189&partnerID=8YFLogxK
U2 - 10.1177/1553350617705207
DO - 10.1177/1553350617705207
M3 - Article
AN - SCOPUS:85023201189
SN - 1553-3506
VL - 24
SP - 373
EP - 378
JO - Surgical Innovation
JF - Surgical Innovation
IS - 4
ER -