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March 18, 1974

Electrosurgical Hazards In Laparoscopy

JAMA. 1974;227(11):1261. doi:10.1001/jama.1974.03230240019011

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To the Editor.—  Dr. Gordon R. Neufeld et al (226:1465, 1973) specifically blamed the Richard Wolf Instrument Corporation for defective equipment. I would like to take issue with their comments and suggest appropriate alternatives. My experience with Wolf laparoscopy equipment exceeds 2,000 laparoscopies in which no electrical burn has occurred due to defective equipment. Though it is true defective equipment can cause electrical burns when spark-gap (Bovie) cautery is used, the usual cause of defective equipment is improper care of laparoscopy equipment. We have a specific team of surgical personnel who inspect and maintain the laparoscopy equipment so that insulation breakdown does not occur. Burns to the patient and to the operator are usually due to improper laparoscopy technique such as applying electrical current with the electrode too close to the tip of the laparoscope.The real answer, however, to preventing electrical burns of the nature described by Dr. Neufeld