Tissue Effects Change as You Modify the Waveform
Electrosurgical Tissue Effects
Grounded Electrosurgical Systems
Isolated Electrosurgical Systems
Patient Return Electrode Monitoring Technology
Electrosurgery Safety Concerns During MIS
Capacitive Coupling During Endoscopy
Recommendations to Avoid Electrosurgical Patient Complications in MIS
Grounded Electrosurgical Systems
RF Current Division
With the phenomenon called current division, the current may split (or divide) and follow more than one path to ground. The circuit to ground is completed whether it travels the intended electrosurgical circuit to the patient return electrode or to an alternate ground referenced site. Patients are thereby exposed to the risk of alternate site burns because (1) current follows the easiest, most conductive path; (2) any grounded object, not just the generator, can complete the circuit; (3) the surgical environment offers many alternative routes to ground; (4) if the resistance of the alternate path is low enough and the current flowing to ground in that path is sufficiently concentrated, an unintended burn may be produced at the alternate grounding site.
Alternate Site Burn
This picture shows an alternate site burn that occurred when a grounded electrosurgical generator was used with a ground referenced ECG device. The ECG electrode provided the path of least resistance to ground; however, it did not disperse the current over a large enough area. The heat produced an alternate site burn under the ECG electrode due to current concentration.