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 delivery. The most common tool is the laparoscopic bipolar forceps. In the last decade variations on this tool, along with other configurations, have been developed that expand the use of bipolar electrosurgery. These variations include bipolar hooks, needles, scissors, forceps with cutting capability and optimised instrument/energy source systems. These new technologies make bipolar electrosurgery a very versatile tool for haemostatic dissection in surgery. This paper reviews laparoscopic bipolar instruments and systems, including the advantages and limitations of each configuration. A new optimised forceps/generator system for surgical vessel-sealing, called the 'LigaSure' (Valleylab Inc., Boulder, CO, USA) vessel-seating system is also discussed. The LigaSure system offers increased reliability with a single application and utility on a broader range of vessel sizes than conventional bipolar electrosurgery. A study comparing seal integrity of standard bipolar coagulation, ultrasonic coagulation and vessel-sealing technology is presented.