Electrosurgery: principles and safety issues.

The use of monopolar electrosurgical energy has been the "gold standard" for the past 50 years. It has diverse capabilities, such as fulguration, precise vaporization, and coaptation of large vessels. Technologic advances in performance and safety have positioned this device as a useful tool in a surgeon's armamentarium. The adaptation of active electrode monitoring for stray energy as a result of insulation failure or capacitive coupling and the use of completely metal trocar cannulas will increase the confidence of the surgeon and the safety of his/ her patient. It is the author's opinion that its use will prove itself in laparoscopy. As with any surgical tool or energy source, education and skill are required. This introduction on the principal of the biophysics of electrical energy on tissue and the safety consideration is a start to further one's understanding of this surgical tool.