Which energy devices are commonly used in laparoscopy for coagulation and cutting, respectively?

Which energy devices are commonly used in laparoscopy for coagulation and cutting, respectively?

• A. Monopolar energy for coagulation and laser fiber for cutting
• B. Bipolar energy for coagulation and ultrasonic (Harmonic) devices for cutting and coagulation with reduced thermal spread
• C. Plasma energy for cutting; Bipolar energy for coagulation
• D. Bipolar energy for cutting and ultrasonic for coagulation only

Answer: (B)

Coagulation and cutting in laparoscopy are most effectively handled when the energy sources limit heat to the target tissue. Bipolar energy confines the current to the tissue between the instrument’s two tips, giving precise coagulation with minimal collateral thermal spread. For cutting with concurrent coagulation, ultrasonic devices such as the Harmonic scalpel use high-frequency vibration to dissect tissue while coagulating through protein denaturation, producing cutting and hemostasis with less lateral heat than traditional electrosurgery. Together, this pairing—bipolar for coagulation and ultrasonic for cutting and coagulation with reduced thermal spread—fits common laparoscopic practice. Other modalities either spread heat more widely or are less routinely used for standard laparoscopy.