Diathermy awareness among surgeons-An analysis in Ireland

Abstract

Introduction: Diathermy is an integral part of many modern surgical procedures. While diathermy is generally accepted as 'safe', electrosurgery-induced injuries are among the more common causes for malpractice litigation. The purpose of this study was to evaluate the awareness among surgeons of the principles, risks, precautions and appropriate use of diathermy.

Methods: All surgeons employed from Senior House Officer (SHO) to Consultant grade in two teaching hospitals were surveyed. Sixty-three surgeons were asked to complete an anonymous questionnaire, which recorded level of training and addressed competence in principles, hazards, and precautions to be taken with diathermy.

Results: Eight Consultants, 5 Specialist Registrars, 19 Registrars and 13 SHO's responded (71% response). All but three subspecialties were represented. Eighty-two percent (37/45) had no formal diathermy training. Despite 89% (40/45) of surgeons regarding diathermy as a safe instrument, 56% felt they had inadequate understanding of the principles and failed to demonstrate an appropriate awareness of the potential risks. Fifty seven percent exhibited a dangerous lack of awareness in managing equipment not yielding the desired effect and 22% were unaware of any patient groups requiring special caution. Only 42% wanted formal training.

Conclusion: Our results show a dearth of awareness among surgeons regarding diathermy. Given our findings, we urge a shift in attitude towards diathermy, with surgeons adopting a more cautious and safe approach to diathermy use. We recommend that formal training be introduced as a hospital based initiative.

Keywords: Awareness; Diathermy; Electrosurgery; Surgeon.

Fig. 1

Electrosurgery current on the radio frequency spectrum.

Fig. 2

The mechanism of monopolar and bipolar diathermy.