Guidance section: ensuring monopolar electrosurgical safety during laparoscopy.

In this study, we have discussed how direct leakage currents flowing through defects in active electrode insulation or capacitive leakage currents originating from the shaft of the active electrode can cause serious patient injuries during laparoscopic monopolar electrosurgical procedures. We have also discussed a number of other surgical scenarios, varying in likelihood, severity, and cause, in which electrosurgical injuries can occur during laparoscopy. This section provides a discussion of protective measures that hospitals can take to reduce the unique risks of serious patient injuries posed by monopolar electrosurgery used laparoscopically. In the Protective Measures for Laparoscopic Monopolar Electrosurgery table, we list our recommendations for reducing the risk of electrosurgical injuries in four common scenarios, as described in the Clinical and Technical Overview.