By Dr. Raymond Lanzafame and Dr. Richard Satava

It is surprising to see how the understanding of certain aspects of energy medicine are not stressed during traditional medical training, given their importance in daily operations and in the surgery of the future. In fact, our identity as surgeons will eventually end up depending on it. You may think you know enough about surgical energy — but ignorance about the topic and its importance is common.

The importance of learning about surgical energy and its future is the reason we are highlighting these technologies in a exciting session being presented at MIS Week in September.



Critical to Understand
As most of us know, surgical energy and energy devices are essential in the modern OR, yet the vast majority of surgeons do not understand the basic principles, applications, and patterns of complications. When Pennsylvania Congressman John Murtha died in 2010, which likely involved an electrosurgical injury, it led to a renewed interest in both research and education in the safe use of surgical energy-based devices. If we can get the surgeon to recognize the patterns of the complications, they can begin to modify how they use energy-based instruments in the OR and avoid the very real risk of surgical energy-based device−related complications.

Surgeons currently are not required to train on specific energy-based devices or to document their knowledge of safety issues related to their use. There are approximately 40,000 burns by electrosurgical devices every year.2 During laparoscopy, 70% of these burns may go undetected. Safety aside, understanding the different surgical energies and the nuances of the devices used to deliver them is critical not only to current operations, but to a surgeon’s future in medicine. The use of molecular energy to operate is not far off.

It is important that we are well versed, as opposed to just generalized, in the mechanisms of the different types and areas of energy medicine application and research in order to understand the future. Our goal is to cover what is most important to know:

• How energy causes effects in cells and tissue, as well as learning the basic function of an electrosurgical generator is important to know. Understanding the applications of electricity requires a basic understanding of the effects of temperature on the cells and tissue.
• Understanding that electro-surgery is about the control of current density, allows the surgeon to increase safety and versatility.

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