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March 18, 1974

Electrosurgical Hazards In Laparoscopy

JAMA. 1974;227(11):1261-1262. doi:10.1001/jama.1974.03230240019013

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To the Editor—  In a recent letter, we outlined the electric shock and burn hazards to personnel during laparoscopic sterilization by electrocautery. Subsequently, we have reviewed the available laparoscopic equipment and find no instruments that adequately safeguard against these hazards. But because of the increased patient morbidity associated with abdominal and vaginal tubal ligation, we have reinstituted laparoscopic tubal sterilization at the Hospital of the University of Pennsylvania with these precautions: (1) An instrument with an insulated eyepiece and forceps handle is used. (2) A low voltage electrocautery device with an isolated output stage is used. (3) Operating personnel is informed on the safe use and attendant hazards of this equipment. (4) A strict preventive maintenance procedure is established.We would have instituted these precautions earlier if manufacturers of this equipment had effectively warned us of these hazards. Our present precautions represent only an interim measure and are not intended