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March 18, 1974

Electrosurgical Hazards In Laparoscopy

Author Affiliations

Pennsylvania Hospital Philadelphia

JAMA. 1974;227(11):1261. doi:10.1001/jama.1974.03230240019010

To the Editor.—  The letter of Neufeld et al (226:1465, 1973) points out some of the electrosurgical risks associated with operative laparoscopy but omits a most important piece of information. The authors identify neither the electrosurgical source nor the settings used. As we discussed in a recent publication,1 the use of spark-gap units at high settings can generate enormous voltages and currents, promoting undesired spread of electrical, or more correctly, high-frequency wave, energy along various undesired pathways.The safest type of unit to use is a solid-state, low-energy machine with isolated circuitry. This factor is of far more importance than laparoscopic design per se and can reduce three-fold the power delivered to the patient. Since we switched to these units, no burn to patient or doctor has been observed.A dielectric eyepiece should be added to the telescope (advocated by most equipment companies) as a simple preventive of facial