“I don’t want what I went through [colon perforation due to an electrosurgical burn caused by capacitive coupling] to become meaningless or to be shrugged off as a complication. I missed 4 months of work, untold pain, the suffering of my children… I have gone through something a lot of people don’t survive…
As a nurse whose major goal my entire life has been to protect my patients, to be my patient’s advocate, it’s very difficult for me to turn a deaf ear to safety issues. [An ESU] is a very powerful piece of equipment and even though we use it every day, many times a day, we can’t forget the real issue of [stray electrosurgical burns] which can happen in just the blink of an eye.”
“AEM® technology is the standard of care within my hospital facilities. With the increase in laparoscopy procedures being performed, I, as a patient advocate, would not consider delivering monopolar energy any other way. Actively monitoring electrosurgical instruments provides me with the guarantee that my patients are safe from stray energy burns and potentially catastrophic injury is prevented.”
Advanced Technology Coordinator
“I have confidence in AEM® technology and no longer perform laparoscopy with monopolar electro-surgery without the AEM system. It is my firm belief that all knowledgeable and cautious laparoscopists will make this same decision as soon as they become aware of this revolutionary new system.”
“The best way to protect your patients from injury and your same-day surgery program from malpractice suits is the implementation of active electrode monitoring [AEM].”
“Use active electrode monitoring devices to monitor and actively shield against stray electrosurgical current. Do not use active electrode monitoring systems with capacitively coupled patient return electrodes.”
“Active electrode montoring should be strongly considered for all laparoscopic monopolar electrosurgery procedures.”
“Utilize … active electrode monitoring to eliminate concerns about insulation failure and capacitive coupling.”
“We …encourage use of electrode shielding (currently the only such device on the market), during laparoscopic monopolar electrosurgery.”
“Consider active electrode monitoring.”
What is Capacitive Coupling?
Capacitive coupling occurs when electrosurgical energy is transferred to the patient without direct contact with the active wire. The fundamental design of all laparoscopic instruments creates a large capacitor, which induces electrical current into the patient without ever contacting the patient’s body. The instrument’s insulation is intact and yet the patient is still burned due to the coupled energy. All monopolar instruments have dangerous levels of capacitive coupling.
What is Insulation Failure?
Insulation failure occurs when there is a hole in the insulation on the shaft of an instrument. This hole allows the full power of the electrosurgical generator to burn the patient in an unintended area.
Insulation failure is extremely common. 1 in 5 reusable instruments has a full thickness insulation failure. 1 in 33 disposable instruments has a failure right out of the package. 57% of insulation failures are not visible to the naked eye.*
*Source: Rate of Insulation Failure: Non-AEM Reusable Monopolar Laparoscopic Instruments