Recommendations to Avoid Electrosurgical Patient Complications in MIS

Most potential problems can be avoided by following these simple guidelines:

Inspect insulation carefully
Use lowest possible power setting
Use a low voltage waveform (cut)
Use brief intermittent activation vs. prolonged activation
Do not activate in open circuit
Do not activate in close proximity or direct contact with another instrument
Use bipolar electrosurgery when appropriate
Select an all metal cannula system as the safest choice. Do not use hybrid cannula systems that mix metal with plastic.
Utilize available technology, such as a tissue response generator to reduce capacitive coupling or an active electrode monitoring system, to eliminate concerns about insulation failure and capacitive coupling.

NOTE: Any cannula system may be used if an active electrode monitor is utilized.