While laparoscopic electrodes are simple instruments in themselves, trying to make sense of the variety of options and configurations available can sometimes be rather complex and confusing for both procurement and clinical staff.
Below is a handy guide outlining the available options of Laparoscopic Electrodes and what they mean for you and your facility.
Reusable or Single-Use
Laparoscopic Electrodes are available as a single-use (disposable) option or reusable option.
Reusable Electrodes are rarely used now due to the risks associated with re-processing, insulation testing, and subsequent burns from insulation failure. The cost of disposable electrodes has reduced over the years as volumes have increased, which further strengthens the case for using disposable options. It is still important to ensure disposable electrodes have a double-insulated shaft for peace of mind and associated risks.
Tip Style
The most common tip style for Laparoscopic Electrodes is the L-Wire/L-Hook configuration, which enables the surgeon to retract, dissect and manipulate tissue as required.
Another standard style is the Spatula tip. This style is mainly used in gynecology and enables the surgeon to coagulate large tissue sections quickly and efficiently.
Other tip styles include Needle Point, Curved Blade, Ball and J-Hook; although these are less common, they still have their place.
Tip Coating
Initially, all Laparoscopic Electrodes were uncoated stainless steel. However, as with standard diathermy electrodes, most facilities now use PTFE-coated, non-stick Laparoscopic Electrodes.
PTFE-Coated tips provide many benefits, including:
- Lower coagulation settings required
- Reduced surgical plume (smoke)[i]
- Greater visibility
- Less irrigation and aspiration required
- Reduced need to remove the electrode to clean the tip
While PTFE-Coated Electrodes may be more expensive to purchase, the time saved by not removing the electrode to clean the tip can save several minutes with every procedure.
All Prima® Laparoscopic Electrodes are PTFE-Coated.
Electrode Size
The length of standard electrodes are between 330mm and 350mm long and are suitable for general use. Larger electrodes are available for bariatric use at 450mm long. There are also shorter electrodes available for pediatrics and are also a
popular option used in veterinary procedures, which are typically around 230mm long.
The standard diameter of Laparoscopic Electrodes is 5mm. However, some surgeons are discovering the benefits[ii] of using smaller 3mm Laparoscopic Instruments, including electrodes, and therefore this size is becoming more readily available.
With or Without a Handle
Originally, reusable Laparoscopic Electrodes consisted of a thin, insulated shaft with a cable attached. As disposable options have evolved, some designs have simply copied the reusable design that surgeons are familiar with, whereas other formats have included handles to assist with ergonomics. The decision on which product to use comes down to surgeon preference.
The Laprosurge® Laparoscopic Electrodes all have an ergonomic handle, whereas the Prima® Laparoscopic Electrodes are available with or without handles.
Foot-Control or Hand-Control
Laparoscopic Electrodes are available to use either with a foot-control (electrode is connected to diathermy console via a monopolar cable), or by inserting into a standard ESU pencil, whereby the electrode is hand-controlled. Foot-controlled electrodes have a 4mm connection, and hand-controlled electrodes have a 2.4mm connection.
While the cost of the electrode is typically the same, using the hand-control method can be more expensive due to the cost of an ESU pencil versus the cost of a monopolar cable.
However, by using the hand-control method, tripping hazards can be reduced from within the theatre space creating a safer surgical working environment.
With or Without Cable
Electrodes can be purchased separately or packaged with a cable (foot-control) or ESU pencil (hand-control).
From a logistics perspective, it can be beneficial to have a single product code to manage, rather than multiple components.
If some components (i.e. monopolar cable) are already in use in the surgical field, then only the electrode itself may be required, which in turn can provide additional cost savings.
For further information about the best Laparoscopic Electrodes for your facility, please get in touch with us at sales@elitemedical.com.au, and your account manager will be only too happy to assist you.
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[i] Kisch T, Liodaki E, Kraemer R, Mailaender P, Brandenburger M, Hellwig Vet al. . Electrocautery devices with feedback mode and Teflon-coated blades create less surgical smoke for a quality improvement in the operating theatre. Medicine (Baltimore) 2015; 94: e1104.
[ii] Bignell, M., Lewis, M. P. N., Cheong, E. C. K., and Rhodes, M. (2013), “A prospective, randomized, single-blind trial of 5-mm versus 3-mm ports for laparoscopic cholecystectomy: is smaller better?”, Surgical Endoscopy, Vol. 27, pp. 3616-3621