AEM® Technology: Conventional Instrument Design

Conventional monopolar instruments have two inherent design weaknesses. First, a conventional instrument consists of a conductor and a single layer of insulation (see Figure 1). If any defects exist before surgery or occur during surgery in this primary layer of insulation, the patient is at risk for a stray electrosurgical burn. Second, conventional monopolar instruments do not have a monitoring system that will continuously check for a dangerous electrical situation during electrode activation during surgery.

Figure 1. Conventional monopolar instrument

Currently, hospitals compensate for these design weaknesses with conventional instruments by conducting the following practices:

• Careful visual scrutiny of the instruments before and/or after surgery*
• High voltage testing or “wanding” the instrument before and/or after surgery
• Extreme care in tray preparation and handling of the instruments
• Purchase of cannulae that are plastic or a combination of plastic/metal*
• Utilization of third-party services to check for and repair insulation failure before and after surgery
• Utilization of lower power settings recommended by monopolar instrument and generator manufacturers for cauterization.*

None of these solutions can entirely prevent a stray electrosurgical burn injury to the patient.

*While Encision recommends these practices with AEM® laparoscopic instruments, these practices alone cannot entirely prevent stray energy burns. Only the use of active electrode monitoring can prevent stray energy burns.

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