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Minimizing Risks in Surgical Procedures with BiPAD® Hand Switching Bipolar Forceps

As a surgeon, you have no doubt learned to coagulate muscular bleeders using forceps and the Monopoly pencil. This is an excellent way to produce collateral damage that can be symptomatic postop. First, we all use COAG mode when we buzz the forceps, which is wrong for many reasons. The best mode for coagulating a blood vessel captured between the forceps tips is CUTTING mode for vessel coagulation, not COAG mode. But even if you use the correct monopoly electrosurgical energy to coagulate optimally, using monopoly electrosurgery for coagulation produces unnecessary collateral damage, both at the surgical site and far afield.

Monopolar electrosurgical instruments put one pole of the circuit in the surgeon's hand (i.e., the monopoly pencil) and the other on the patient's hip as a "dispersive electrode." In other words, the patient is part of the circuit. Current, alternating at ~500KHz, passes between the monopoly tip to the dispersive electrode following a path of least resistance, which could be your patient's hip joint in you and the staff are not careful.

In contrast, bipolar instruments, like bipolar forceps, limit current flow to the space between the tips of the forceps. The only part of the patient in the circuit is the tissue between the tips of the forceps and possibly up to two millimeters beyond.

So why do surgeons "buzz" forceps with monocular pencils? The answer is that surgeons hate that bipolar forceps must be activated using a foot pedal, and they despise the time wasted looking for the foot pedal or having a nurse come under the table to move it. The monopolar pencil has a built-in hand switch, making it the preferred, albeit a riskier, form of electrosurgery.

BiPAD® hand switches for bipolar forceps change the equation. The BiPAD® cord with an integrated hand-switch converts any forceps into hand-switched forceps. The devices save time, anguish, nursing disparagement, and surgeon postural pain associated with the bipolar foot pedal. Now there is no reason to make the patient part of the electrosurgical circuit every time you need to achieve hemostasis — Use BiPAD®!

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