Bipolar electrosurgery: Convention and innovation

Bipolar electrosurgery is part of the customary gynecologic surgical armamentarium providing isolated thermal effects and blood vessel occlusion. However, end points are not always predictable as hemostasis may require contiguous applications and thermal damage can significantly expand beyond the target zone. Unintentional transection of a patent vessel cannot be entirely reduced. Recent advances in bipolar technology provide more predictable vessel occlusion with less thermal damage. To date, there are 3 novel bipolar platforms, using either impedance feedback from the operative site to moderate output as pulsed current with lower voltage or by local regulation using nanotechnology within the jaws.