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Electrical considerations of laparoscopic sterilization.

The electrosurgical aspects of laparoscopic sterilization are discussed including an examination of different electrical instruments and the power they produce. The history of the use of electrical instruments in surgery is reviewed as well as the basic principles of electrosurgery and the procedures and precautions that should be followed. 35 cases of sterilization with electrosurgical equipment were studied and voltage current and power generated during these procedures were measured and compared. The Leibel Flarsheim CSV Bovie unit was used in 4 transurethral resection cases and 9 coagulations as part of laparoscopic sterilizations. During cutting procedures the average voltage in these operations was 228 volts the average current was 519 milliamperes and the power averaged 112 watts. In coagulation procedures the voltage was 109 volts current 324 milliamperes and power 35 watts. A newer smaller unit the Cameron-Miller coagulator delivered more current at lower voltage with less variation producing an average 99 volts 429 milliamperes and 44 watts. It is noted that the cutting procedures produced much greater electrical activity than the coagulating procedures and are considered more dangerous and should be avoided. Specific recommendations are made to improve electrosurgical techniques in sterilization procedures.