BIPOLAR LAPAROSCOPIC MONITOR WITH MUSICAL COAGULATION INDICATOR (FOR USE WITH AVAILABLE BIPOLAR GENERATOR)

 Bipolar laparoscopic coagulation of the fallopian tube has become an accepted and widespread method of female sterilization. It has replaced unipolar coagulation to a large extent, because it reduces the risk of burn injuries. Ayers (1), Soderstrom (2), Seiler (3), Barnes (4), Kleppinger (5) reported on pregnancies after bipolar laparoscopic coagulation of the fallopian tube. A respective discussion in the literature (Hausner) expressed various theories of the cause of failure - (see following Literature Review). Soderstrom experimented with various designs of laparoscopic forceps energized by different bipolar generators. He concluded that a coagulation monitor gives the greatest assurance for effective bipolar coagulation. Since the physician performing laparoscopic tubal coagulation has to observe the operation through the laparoscope, he cannot at the same time look at the monitor on the bipolar generator. We developed such a musical indicator and incorporated it in our bipolar coagulator as well as in our adjunctive monitor for use with other bipolar units. With the additional audible coagulation indicator, the laparoscopist can observe the performance of the coagulation process visually at the fallopian tube and audibly from the generator. This innovation should be an enormously valuable adjunct in the direction of safety for laparoscopic fallopian tube coagulation. (Developed in collaboration with Drs. Hulka and Soderstrom). The L.E.D. bar graph of the unit may also be used to test out the bipolar forceps and RF-cables for proper functions, prior to the surgical intervention. Our observations and those of our associated doctors also provide evidence that laparoscopic bipolar forceps with a spring loaded pressure, such as the ELMED 52105-67 and 52205-86 (request details on expanded line of forceps), are superior with respect to consistent through and through coagulation, because there is no dependence on the pressure exerted by the surgeon on the jaws of the forceps.