Use of the electrosurgical unit in a carbon dioxide atmosphere

Abstract

The electrosurgical unit (ESU) utilizes an electrical discharge to cut and coagulate tissue and is often held above the surgical site, causing a spark to form. The voltage at which the spark is created, termed the breakdown voltage, is governed by the surrounding gaseous environment. Surgeons are now utilizing the ESU laparoscopically with carbon dioxide insufflation, potentially altering ESU operating characteristics. This study examines the clinical implications of altering gas composition by measuring the spark gap distance as a marker of breakdown voltage and use of the ESU on a biologic model, both in room air and carbon dioxide. Paschen’s Law predicted a 35% decrease in gap distance in carbon dioxide, while testing revealed an average drop of 37–47% as compared to air. However, surgical model testing revealed no perceivable clinical difference. Electrosurgery can be performed in carbon dioxide environments, although surgeons should be aware of potentially altered ESU performance.

Keywords:

• Electrosurgical unit
• carbon dioxide
• breakdown voltage
• Paschen’s Law

Acknowledgements

The research team appreciates the kind help of Holly Roten of the Scott & White Hospital Bioengineering Department with technical equipment support during testing.

Disclosure statement

The authors report no conflicts of interest, with the exception of W. C. Culp, Jr., who has patent interests in an operating room safety device.

Funding information

This study was funded through a Research Mentor Award grant from Scott & White Memorial Hospital, along with routine departmental and institutional support.