ELECTROSURGICAL SAFETY OF GUIDE WIRES DURING ENDOSCOPIC SPHINCTEROTOMY

A study was performed to determine whether alternate site electrosurgi cal bums could be caused by an inadequately insulated guide wire left in place during endoscopic papillotomy to maintain cannulation of the common bile duct. The safety of four covered guide wires and one stand ard guide wire was evaluated for electrosurgical safety. All four cove red guide wires were coated with polyurethane or polytetrafluoroethyle ne (Teflon), providing insulation. Leakage currents under normal, limi ting case, and fault (damaged insulation) conditions were compared to safety limits. All covered guide wires met safety limits under normal conditions, one of four covered guide wires met safety limits under li miting case conditions, and none met safety limits under fault conditi ons. The uncovered guide wire did not meet the safety limit under any conditions. Conclusion: Without a well-insulated guide wire with intac t coating, our measurements indicate that leaving a guide wire in plac e during papillotomy may result in an electrosurgical burn.