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The Art of Electrosurgery: Trainees and Experts

The benefits of electrosurgery have been acknowledged since the early 1920s, and nowadays more than 80% of surgical procedures involve devices that apply energy to tissues. Despite its widespread use, it is currently unknown how the operator’s choices with regard to instrument selection and applicat...

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Autores principales: Meeuwsen, Frédérique C., Guédon, Annetje C. P., Arkenbout, Ewout A., van der Elst, Maarten, Dankelman, Jenny, van den Dobbelsteen, John J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505226/
https://www.ncbi.nlm.nih.gov/pubmed/28438057
http://dx.doi.org/10.1177/1553350617705207
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author Meeuwsen, Frédérique C.
Guédon, Annetje C. P.
Arkenbout, Ewout A.
van der Elst, Maarten
Dankelman, Jenny
van den Dobbelsteen, John J.
author_facet Meeuwsen, Frédérique C.
Guédon, Annetje C. P.
Arkenbout, Ewout A.
van der Elst, Maarten
Dankelman, Jenny
van den Dobbelsteen, John J.
author_sort Meeuwsen, Frédérique C.
collection PubMed
description The benefits of electrosurgery have been acknowledged since the early 1920s, and nowadays more than 80% of surgical procedures involve devices that apply energy to tissues. Despite its widespread use, it is currently unknown how the operator’s choices with regard to instrument selection and application technique are related to complications. As such, the manner in which electrosurgery is applied can have a serious influence on the outcome of the procedure and the well-being of patients. The aim of this study is to investigate the variety of differences in usage of electrosurgical devices. Our approach is to measure these parameters to provide insight into application techniques. A sensor was developed that records the magnitude of electric current delivered to an electrosurgical device at a frequency of 10 Hz. The sensor is able to detect device activation times and a reliable estimate of the power-level settings. Data were recorded for 91 laparoscopic cholecystectomies performed by different surgeons and residents. Results of the current measurement data show differences in the way electrosurgery is applied by surgeons and residents during a laparoscopic cholecystectomy. Variations are seen in the number of activations, the activation time, and the approach for removal of the gallbladder. Analysis showed that experienced surgeons have a longer activation time than residents (3.01 vs 1.41 seconds, P < .001) and a lower number of activations (102 vs 123). This method offers the opportunity to relate application techniques to clinical outcome and to provide input for the development of a best practice model.
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spelling pubmed-55052262017-07-25 The Art of Electrosurgery: Trainees and Experts Meeuwsen, Frédérique C. Guédon, Annetje C. P. Arkenbout, Ewout A. van der Elst, Maarten Dankelman, Jenny van den Dobbelsteen, John J. Surg Innov Surgical Education: Training for the future The benefits of electrosurgery have been acknowledged since the early 1920s, and nowadays more than 80% of surgical procedures involve devices that apply energy to tissues. Despite its widespread use, it is currently unknown how the operator’s choices with regard to instrument selection and application technique are related to complications. As such, the manner in which electrosurgery is applied can have a serious influence on the outcome of the procedure and the well-being of patients. The aim of this study is to investigate the variety of differences in usage of electrosurgical devices. Our approach is to measure these parameters to provide insight into application techniques. A sensor was developed that records the magnitude of electric current delivered to an electrosurgical device at a frequency of 10 Hz. The sensor is able to detect device activation times and a reliable estimate of the power-level settings. Data were recorded for 91 laparoscopic cholecystectomies performed by different surgeons and residents. Results of the current measurement data show differences in the way electrosurgery is applied by surgeons and residents during a laparoscopic cholecystectomy. Variations are seen in the number of activations, the activation time, and the approach for removal of the gallbladder. Analysis showed that experienced surgeons have a longer activation time than residents (3.01 vs 1.41 seconds, P < .001) and a lower number of activations (102 vs 123). This method offers the opportunity to relate application techniques to clinical outcome and to provide input for the development of a best practice model. SAGE Publications 2017-04-24 2017-08 /pmc/articles/PMC5505226/ /pubmed/28438057 http://dx.doi.org/10.1177/1553350617705207 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Surgical Education: Training for the future
Meeuwsen, Frédérique C.
Guédon, Annetje C. P.
Arkenbout, Ewout A.
van der Elst, Maarten
Dankelman, Jenny
van den Dobbelsteen, John J.
The Art of Electrosurgery: Trainees and Experts
title The Art of Electrosurgery: Trainees and Experts
title_full The Art of Electrosurgery: Trainees and Experts
title_fullStr The Art of Electrosurgery: Trainees and Experts
title_full_unstemmed The Art of Electrosurgery: Trainees and Experts
title_short The Art of Electrosurgery: Trainees and Experts
title_sort art of electrosurgery: trainees and experts
topic Surgical Education: Training for the future
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505226/
https://www.ncbi.nlm.nih.gov/pubmed/28438057
http://dx.doi.org/10.1177/1553350617705207
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