• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

The Monopolar ‘Bovie’ Instrument: Pattern of Use Analysis

Lauren R Wilson, MD, Nicole T Townsend, MD, Thomas N Robinson, MD. University of Colorado Department of Surgery

BACKGROUND:

The monopolar “Bovie” instrument is ubiquitous. It is used by all surgical specialties on almost all surgical cases. The power delivered by the monopolar generator provides the end-user with a variety of settings to achieve different tissue effects, however patterns of use are unknown. The PURPOSE of this study is to determine the patterns with which surgeons use the monopolar instrument.

STUDY DESIGN:

We collected retrospective electronic data on consecutive activations of the monopolar instrument from four separate medical centers’ electrosurgical generator units. Outcome variables included generator power in Watts (W), generator mode setting (cut, coagulation [coag], or blend), and duration of activation in seconds (s). Statistical analysis included non-parametric unpaired t-test for continuous variables and chi-square test for dichotomous variables.

RESULTS:

6,666 consecutive monopolar instrument activations were analyzed over 39 generator units.

GENERATOR POWER: The most common power setting was 30 Watts (22% of activations, n=1,494) and settings of 25-35W were used 50% of the time (n=3,334). When using coag mode, the average power setting was 39±16W. When using cut mode, the average power was significantly higher at 60W (39±16W v. 60±71W; p<0.0001). Similar to cut mode, average power settings on blend mode were significantly higher at 54W (39±16W v. 54±64W; p<0.0001).

GENERATOR MODE: The most common monopolar mode was coag (high voltage, 6% duty cycle), used 84.8% (n=5,654) of the time, and significantly more frequently than both other modes. In comparison, cut mode (low voltage, 100% duty cycle) was used 10.9% (n=728) of the time, while blend mode (variation in voltage and duty cycle to produce desired clinical effects of coaglation v. cutting) was used only 4.3% (n=284) of the time (5,654 coag activations v. 1,112 non-coag activations; p<0.0001). Although both were used significantly less than coag, cut was used more significantly than blend (cut activations v. blend activations, p<0.0001).

ACTIVATION TIME: Average activation time for coag mode was significantly longer than cut (3±3s v. 2±2s p<0.0001) or blend (3±3s v. 2±2s, p<0.0001) modes. Cut mode and blend mode activation times were not significantly different (2±2s v. 2±2s, p=1.000).

CONCLUSIONS:

The monopolar instrument is repetitively used on the same power and mode settings. The single power setting of 30 Watts is used 22% of the time with settings of 25-35W used for half of all activations. Coagulation mode is used in 85% of activations. These findings suggest that this instrument, which contains advanced technology with flexible settings, is underutilized by the surgical community. Use of multiple settings can help the surgeon achieve a range of tissue effects, including dessication, fulguration, and vaporization, which can improve tissue cutting and hemostasis. Improved understanding of these patterns of use can identify what additional settings could be used to achieve desired tissue effects. This study may imply that surgeons need additional training in non-standard settings of the monopolar instrument.

801

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2015 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons