Current guidelines for safe electro-surgery: Open, laparoscopic, and robotic approaches

Energy devices are central to modern surgical practice across open, laparoscopic, and robotic platforms. Conventional electrosurgery remains widely used; however, ultrasonic technology particularly the Harmonic Scalpel has gained prominence due to reduced thermal spread, improved hemostasis, and superior postoperative outcomes. This article reviews recent high-level evidence comparing harmonic technology, bipolar vessel sealers, lasers, and conventional electrosurgery, with a focused discussion on gynaecologic surgery. Meta-analyses and randomized controlled trials consistently demonstrate reduced blood loss, operative time, postoperative pain, and complication rates with ultrasonic and advanced bipolar systems. Practical clinical guidance and safety considerations are highlighted to support evidence-based device selection in gynaecologic practice.