A Review of Capacitive Return Electrodes in Electrosurgery

Paul Richard Borgmeier; Crystal Diane Ricketts; Jeffrey Warren Clymer; Gaurav Gangoli; Giovanni Antonio Tommaselli

doi:doi:10.11648/j.js.20210901.16

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A Review of Capacitive Return Electrodes in Electrosurgery

Paul Richard Borgmeier, Crystal Diane Ricketts, Jeffrey Warren Clymer, Gaurav Gangoli, Giovanni Antonio Tommaselli

Published in Journal of Surgery (Volume 9, Issue 1)

Received: 19 January 2021 Accepted: 29 January 2021 Published: 9 February 2021

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Abstract

Background: Monopolar electrosurgery, one of the most widely used techniques in surgery, requires two electrodes: a working electrode and a return electrode. Commonly, adhesive or “sticky” pads that attach directly to the patient are used as return electrodes. Acting as electrolytic conductors, adhesive pads are highly effective, but require some effort to apply and remove, and if improperly placed or partially detached may lead to high electrical current density and the potential for pad site burns. Alternatively, a capacitive return electrode, such as the Mega Soft pad, may be used that works on the same principle as a two-plate capacitor. Objective: This article details the technology underlying capacitive electrodes, reviews the scientific literature to-date, and provides recommendations on how to best use the Mega Soft pad. Results: No direct contact is required between the pad and patient, and the return electrode is designed so that current density is limited regardless of pad placement, reducing the risk of pad site burn. Although the technology is now mature, having been in the field for over 20 years, best practices for optimal performance from capacitive return electrodes are still not widespread, and misunderstandings persist regarding use of capacitive electrodes with contact monitoring systems and implantable electronic devices. Conclusion: With proper training, capacitive return electrodes may be substituted for conventional adhesive pads with the benefits of easier application and reduced risk of pad site burns.

Published in	Journal of Surgery (Volume 9, Issue 1)
DOI	10.11648/j.js.20210901.16
Page(s)	31-35
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Monopolar Electrosurgery, Adhesive Return Electrode, Capacitive Return Electrode, Pad Site Burns

References

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[2]	Ricketts, C. D., et al., Evaluation of an intuitive, intelligent electrosurgical generator. Med Devices Diagn Eng, 2020. 5: p. 1-5.
[3]	Ricketts, C. D., et al., A modern surgical smoke evacuator for the challenges of today’s operating room. Med Res Innov, 2020. 4: p. 1-5.
[4]	Lee, B. J., et al., Advanced cutting effect system versus cold steel scalpel: comparative wound healing and scar formation in targeted surgical applications. Plastic and Reconstructive Surgery Global Open, 2014. 2 (10).
[5]	Lee, B., J. Clymer, and R. Lewis Comparative Damage to Tissue Created By Two Advanced Electrosurgery Devices. Surg Res Pract, 2017. 1 (1): p. 1-4.
[6]	Meeuwsen, F. C., et al., The art of electrosurgery: trainees and experts. Surgical innovation, 2017. 24 (4): p. 373-378.
[7]	Liodaki, E., et al., Noncontact electrosurgical grounding–A useful and safe tool in the initial surgical management of thermal injuries. Burns, 2013. 39 (1): p. 142-145.
[8]	ECRI Institute, Evaluation Background: Capacitive Electrosurgical Return Electrodes. Health Devices, 2020.
[9]	Sheridan, R. L., et al., Noncontact electrosurgical grounding is useful in burn surgery. The Journal of burn care & rehabilitation, 2003. 24 (6): p. 400-401.
[10]	Baeg, M. K., et al., Endoscopic electrosurgery in patients with cardiac implantable electronic devices. Clinical Endoscopy, 2016. 49 (2): p. 176.
[11]	Rozner, M. A., E. A. Kahl, and P. M. Schulman, Inappropriate implantable cardioverter-defibrillator therapy during surgery: an important and preventable complication. Journal of cardiothoracic and vascular anesthesia, 2017. 31 (3): p. 1037-1041.
[12]	Gifford, J., et al., ICD-ON registry for perioperative management of CIEDs: Most require no change. Pacing and Clinical Electrophysiology, 2017. 40 (2): p. 128-134.
[13]	Schulman, P. M., et al., Electromagnetic interference with protocolized electrosurgery dispersive electrode positioning in patients with implantable cardioverter defibrillators. Anesthesiology: The Journal of the American Society of Anesthesiologists, 2019. 130 (4): p. 530-540.
[14]	Lefevre, R. J., et al., Unintended ICD discharge in a patient undergoing bladder tumor resection utilizing monopolar cautery and full-body return electrode. Journal of Cardiovascular Electrophysiology, 2020.
[15]	Tully, B. W., N. S. Gerstein, and P. M. Schulman, Electromagnetic interference with an underbody dispersive electrode in a patient with an implantable cardioverter-defibrillator undergoing noncardiac surgery: a case report. A&A Practice, 2020. 14 (11): p. e01285.
[16]	Park, S. S., J. A. Lim, and J. S. Yeo, Intraoperative electrical burn caused by stainless tube tree with noncontact electrosurgical ground: A case report. Anesthesia and Pain Medicine, 2014. 9 (4): p. 274-276.

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APA Style

Paul Richard Borgmeier, Crystal Diane Ricketts, Jeffrey Warren Clymer, Gaurav Gangoli, Giovanni Antonio Tommaselli. (2021). A Review of Capacitive Return Electrodes in Electrosurgery. Journal of Surgery, 9(1), 31-35. https://doi.org/10.11648/j.js.20210901.16

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ACS Style

Paul Richard Borgmeier; Crystal Diane Ricketts; Jeffrey Warren Clymer; Gaurav Gangoli; Giovanni Antonio Tommaselli. A Review of Capacitive Return Electrodes in Electrosurgery. J. Surg. 2021, 9(1), 31-35. doi: 10.11648/j.js.20210901.16

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AMA Style

Paul Richard Borgmeier, Crystal Diane Ricketts, Jeffrey Warren Clymer, Gaurav Gangoli, Giovanni Antonio Tommaselli. A Review of Capacitive Return Electrodes in Electrosurgery. J Surg. 2021;9(1):31-35. doi: 10.11648/j.js.20210901.16

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@article{10.11648/j.js.20210901.16,
  author = {Paul Richard Borgmeier and Crystal Diane Ricketts and Jeffrey Warren Clymer and Gaurav Gangoli and Giovanni Antonio Tommaselli},
  title = {A Review of Capacitive Return Electrodes in Electrosurgery},
  journal = {Journal of Surgery},
  volume = {9},
  number = {1},
  pages = {31-35},
  doi = {10.11648/j.js.20210901.16},
  url = {https://doi.org/10.11648/j.js.20210901.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210901.16},
  abstract = {Background: Monopolar electrosurgery, one of the most widely used techniques in surgery, requires two electrodes: a working electrode and a return electrode. Commonly, adhesive or “sticky” pads that attach directly to the patient are used as return electrodes. Acting as electrolytic conductors, adhesive pads are highly effective, but require some effort to apply and remove, and if improperly placed or partially detached may lead to high electrical current density and the potential for pad site burns. Alternatively, a capacitive return electrode, such as the Mega Soft pad, may be used that works on the same principle as a two-plate capacitor. Objective: This article details the technology underlying capacitive electrodes, reviews the scientific literature to-date, and provides recommendations on how to best use the Mega Soft pad. Results: No direct contact is required between the pad and patient, and the return electrode is designed so that current density is limited regardless of pad placement, reducing the risk of pad site burn. Although the technology is now mature, having been in the field for over 20 years, best practices for optimal performance from capacitive return electrodes are still not widespread, and misunderstandings persist regarding use of capacitive electrodes with contact monitoring systems and implantable electronic devices. Conclusion: With proper training, capacitive return electrodes may be substituted for conventional adhesive pads with the benefits of easier application and reduced risk of pad site burns.},
 year = {2021}
}

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TY  - JOUR
T1  - A Review of Capacitive Return Electrodes in Electrosurgery
AU  - Paul Richard Borgmeier
AU  - Crystal Diane Ricketts
AU  - Jeffrey Warren Clymer
AU  - Gaurav Gangoli
AU  - Giovanni Antonio Tommaselli
Y1  - 2021/02/09
PY  - 2021
N1  - https://doi.org/10.11648/j.js.20210901.16
DO  - 10.11648/j.js.20210901.16
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 31
EP  - 35
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20210901.16
AB  - Background: Monopolar electrosurgery, one of the most widely used techniques in surgery, requires two electrodes: a working electrode and a return electrode. Commonly, adhesive or “sticky” pads that attach directly to the patient are used as return electrodes. Acting as electrolytic conductors, adhesive pads are highly effective, but require some effort to apply and remove, and if improperly placed or partially detached may lead to high electrical current density and the potential for pad site burns. Alternatively, a capacitive return electrode, such as the Mega Soft pad, may be used that works on the same principle as a two-plate capacitor. Objective: This article details the technology underlying capacitive electrodes, reviews the scientific literature to-date, and provides recommendations on how to best use the Mega Soft pad. Results: No direct contact is required between the pad and patient, and the return electrode is designed so that current density is limited regardless of pad placement, reducing the risk of pad site burn. Although the technology is now mature, having been in the field for over 20 years, best practices for optimal performance from capacitive return electrodes are still not widespread, and misunderstandings persist regarding use of capacitive electrodes with contact monitoring systems and implantable electronic devices. Conclusion: With proper training, capacitive return electrodes may be substituted for conventional adhesive pads with the benefits of easier application and reduced risk of pad site burns.
VL  - 9
IS  - 1
ER  -

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Author Information

Paul Richard Borgmeier

Medical Affairs, Ethicon, Inc., Cincinnati, the United States
Crystal Diane Ricketts

Medical Affairs, Ethicon, Inc., Cincinnati, the United States
Jeffrey Warren Clymer

Medical Affairs, Ethicon, Inc., Cincinnati, the United States
Gaurav Gangoli

Medical Affairs, Ethicon, Inc., Cincinnati, the United States
Giovanni Antonio Tommaselli

Medical Affairs, Ethicon, Inc., Cincinnati, the United States

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Plain Text BibTeX RIS

APA Style

Paul Richard Borgmeier, Crystal Diane Ricketts, Jeffrey Warren Clymer, Gaurav Gangoli, Giovanni Antonio Tommaselli. (2021). A Review of Capacitive Return Electrodes in Electrosurgery. Journal of Surgery, 9(1), 31-35. https://doi.org/10.11648/j.js.20210901.16

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ACS Style

Paul Richard Borgmeier; Crystal Diane Ricketts; Jeffrey Warren Clymer; Gaurav Gangoli; Giovanni Antonio Tommaselli. A Review of Capacitive Return Electrodes in Electrosurgery. J. Surg. 2021, 9(1), 31-35. doi: 10.11648/j.js.20210901.16

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AMA Style

Paul Richard Borgmeier, Crystal Diane Ricketts, Jeffrey Warren Clymer, Gaurav Gangoli, Giovanni Antonio Tommaselli. A Review of Capacitive Return Electrodes in Electrosurgery. J Surg. 2021;9(1):31-35. doi: 10.11648/j.js.20210901.16

Copy | Download

@article{10.11648/j.js.20210901.16,
  author = {Paul Richard Borgmeier and Crystal Diane Ricketts and Jeffrey Warren Clymer and Gaurav Gangoli and Giovanni Antonio Tommaselli},
  title = {A Review of Capacitive Return Electrodes in Electrosurgery},
  journal = {Journal of Surgery},
  volume = {9},
  number = {1},
  pages = {31-35},
  doi = {10.11648/j.js.20210901.16},
  url = {https://doi.org/10.11648/j.js.20210901.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210901.16},
  abstract = {Background: Monopolar electrosurgery, one of the most widely used techniques in surgery, requires two electrodes: a working electrode and a return electrode. Commonly, adhesive or “sticky” pads that attach directly to the patient are used as return electrodes. Acting as electrolytic conductors, adhesive pads are highly effective, but require some effort to apply and remove, and if improperly placed or partially detached may lead to high electrical current density and the potential for pad site burns. Alternatively, a capacitive return electrode, such as the Mega Soft pad, may be used that works on the same principle as a two-plate capacitor. Objective: This article details the technology underlying capacitive electrodes, reviews the scientific literature to-date, and provides recommendations on how to best use the Mega Soft pad. Results: No direct contact is required between the pad and patient, and the return electrode is designed so that current density is limited regardless of pad placement, reducing the risk of pad site burn. Although the technology is now mature, having been in the field for over 20 years, best practices for optimal performance from capacitive return electrodes are still not widespread, and misunderstandings persist regarding use of capacitive electrodes with contact monitoring systems and implantable electronic devices. Conclusion: With proper training, capacitive return electrodes may be substituted for conventional adhesive pads with the benefits of easier application and reduced risk of pad site burns.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - A Review of Capacitive Return Electrodes in Electrosurgery
AU  - Paul Richard Borgmeier
AU  - Crystal Diane Ricketts
AU  - Jeffrey Warren Clymer
AU  - Gaurav Gangoli
AU  - Giovanni Antonio Tommaselli
Y1  - 2021/02/09
PY  - 2021
N1  - https://doi.org/10.11648/j.js.20210901.16
DO  - 10.11648/j.js.20210901.16
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 31
EP  - 35
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20210901.16
AB  - Background: Monopolar electrosurgery, one of the most widely used techniques in surgery, requires two electrodes: a working electrode and a return electrode. Commonly, adhesive or “sticky” pads that attach directly to the patient are used as return electrodes. Acting as electrolytic conductors, adhesive pads are highly effective, but require some effort to apply and remove, and if improperly placed or partially detached may lead to high electrical current density and the potential for pad site burns. Alternatively, a capacitive return electrode, such as the Mega Soft pad, may be used that works on the same principle as a two-plate capacitor. Objective: This article details the technology underlying capacitive electrodes, reviews the scientific literature to-date, and provides recommendations on how to best use the Mega Soft pad. Results: No direct contact is required between the pad and patient, and the return electrode is designed so that current density is limited regardless of pad placement, reducing the risk of pad site burn. Although the technology is now mature, having been in the field for over 20 years, best practices for optimal performance from capacitive return electrodes are still not widespread, and misunderstandings persist regarding use of capacitive electrodes with contact monitoring systems and implantable electronic devices. Conclusion: With proper training, capacitive return electrodes may be substituted for conventional adhesive pads with the benefits of easier application and reduced risk of pad site burns.
VL  - 9
IS  - 1
ER  -

Copy | Download