Fenestrated Bipolar Forceps (da Vinci)
Fenestrated bipolar forceps combine windowed grasping jaws with bipolar coagulation. They provide a different tissue purchase from the fine curved Maryland bipolar, but broad jaws do not make retraction or energy delivery atraumatic.
Platform and Geometry
The manufacturer lists the baseline multiport fenestrated bipolar as 8 mm, including the X/Xi portfolio; the separate 5 mm Single-Site product must not be conflated with this multiport EndoWrist instrument. SP fenestrated bipolar and da Vinci 5 force-feedback variants are separate products. Confirm the exact part, platform, generator compatibility and permitted use or reprocessing life.[1][2]
The X/Xi manual identifies the 5 mm Single-Site bipolar products as single-use; the baseline EndoWrist products have a different use or reprocessing specification.[4]
The fenestrations and jaw shape can help hold tissue for exposure. Use enough purchase for the task while avoiding crushing, tearing or prolonged traction on delicate ureter, bowel, vaginal wall or reconstructive tissue. A broad contact surface is not an indication for indiscriminate energized surface sweeping.
Reconstructive Use
Task-based examples include exposure during bladder mobilization, countertraction on clearly identified scar or mesh, and selective hemostasis in pelvic dissection. The actual tissue condition and intended repair determine where and how to grasp.
| Need | Consideration |
|---|---|
| Broad grasp and countertraction with occasional coagulation | Fenestrated bipolar may combine these functions in one arm. |
| Fine-tip plane development | Maryland offers a narrower curved working end. |
| Temporary stronger grip | Force Bipolar has selectable grip on compatible systems. |
| Defined pedicle sealing and division | Conventional fenestrated bipolar is not interchangeable with a vessel sealer. Use suitable vascular control. |
A two-bipolar setup is one possible arrangement for bimanual dissection and hemostasis. Cross-specialty feasibility or technique reports do not prove shorter operating time, lower costs or better reconstructive outcomes for every sacrocolpopexy, fistula repair or ureteral reconstruction. Saline-assisted liver-parenchymal techniques should not be transferred as a standard pelvic protocol.
Energy Safety
Follow the specific instrument and energy-system instructions. Do not reuse a generic “3 or 4” setting, a monopolar waveform name, or an automatic-stop assumption across different generators. Automatic feedback does not convert this grasper into a device with a defined 5–7 mm sealing indication.
Bipolar heat can extend beyond the jaws and persist after activation. Published experimental thermal spreads depend on tissue, device, power, duration and the injury threshold chosen. In a bovine-tissue bench study using 45°C as the nerve-injury threshold, adjustable bipolar instruments spread heat 2.2 mm at 60 W for 1 s and 3.6 mm at 2 s, and a second Maryland clamp used as a heat sink reduced spread. A 2–3 mm margin is not a validated guarantee of nerve, ureter or bowel safety. Keep the target and working end visible; use brief, appropriate activation and account for residual heat. Cold dissection or nonthermal hemostasis may better preserve vulnerable structures.[3]
See also: Energy Devices, Maryland Bipolar, Force Bipolar, ProGrasp, Gerald Bipolar.
References
1. Intuitive. Da Vinci energy instruments and platform compatibility. Current manufacturer information; energy portfolio, baseline 8 mm instruments. Accessed September 2026.
2. US FDA. Da Vinci SP Instruments, K241814. November 18, 2024. Device summary and instrument tables.
3. Hefermehl LJ, Largo RA, Hermanns T, et al. Lateral temperature spread of monopolar, bipolar and ultrasonic instruments for robot-assisted laparoscopic surgery. BJU Int. 2014;114(2):245–252. doi:10.1111/bju.12498.
4. Intuitive. Da Vinci Xi and X Instruments and Accessories User Manual, 553873-07 Rev. D. Chapter 8. Manufacturer manual.