Recent innovations in bipolar electrosurgery

Bipolar electrosurgery has been used routinely in endoscopic surgery since its inception and is associated with increased safety and precise energy de livery. The most common tool is the laparoscopic bipolar forceps. In the la st decade variations on this tool, along with other configurations, have be en developed that expand the use of bipolar electrosurgery. These variation s include bipolar hooks, needles, scissors, forceps with cutting capability and optimised instrument/energy source systems. These new technologies mak e bipolar electrosurgery a very versatile tool for haemostatic dissection i n surgery. This paper reviews laparoscopic bipolar instruments and systems, including the advantages and limitations of each configuration. A new opti mised forceps/generator system for surgical vessel-sealing, called the 'Lig aSure' (Valleylab Inc., Boulder, CO, USA) vessel-seating system is also dis cussed. The LigaSure system offers increased reliability with a single appl ication and utility on a broader range of vessel sizes than conventional bi polar electrosurgery. A study comparing seal integrity of standard bipolar coagulation, ultrasonic coagulation and vessel-sealing technology is presen ted.