Patent Publication Number: US-2021169572-A1

Title: Electrical return connections for electrosurgical systems

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims priority to and the benefit of U.S. Patent Application No. 62/944,266, filed Dec. 5, 2019, and entitled ELECTRICAL RETURN CONNECTIONS FOR ELECTROSURGICAL SYSTEMS, the entire content of which is incorporated herein by reference. 
    
    
     BACKGROUND 
     1. Technical Field 
     The present disclosure relates generally to electrosurgical systems. In particular, the present disclosure relates to connections for electrical return cables for electrosurgical return electrodes. 
     2. The Relevant Technology 
     In the area of electrosurgery, medical procedures of cutting tissue and/or cauterizing leaking blood vessels are performed by utilizing radio frequency (RF) electrical energy. As is known to those skilled in the medical arts, electrosurgery is widely used and offers many advantages including that of the use of a single surgical tool for both cutting and coagulation. The RF energy is produced by an RF energy source, such as a wave generator or Electro-Surgical Unit (ESU), and transmitted to a patient&#39;s tissue through a hand-held electrode that is operated by a surgeon. 
     Monopolar electrosurgical generator systems have an active electrode that is applied by the surgeon to the patient at the surgical site to perform surgery and a return path from the patient back to the ESU. The active electrode at the point of contact with the patient must be small in size to produce a high current density in order to produce a surgical effect of cutting or coagulating tissue. The return electrode, which carries the same current as the active electrode, has a large enough effective surface area in contact with the patient such that a low density current flows from the patient to the return electrode. An electrical return cable connected to the return electrode provides a conventional electrical return to the electrosurgical radio frequency energy source. 
     Since the inception of electrosurgery, various types of return electrodes have been used, including self-limiting return electrodes. Unlike typical sticky pads and steel plate return electrodes, self-limiting return electrodes are relatively large, thereby eliminating the need for conductive gels that may irritate a patient&#39;s skin. Additionally, self-limiting return electrodes typically employ geometries and materials whose impedance characteristics, at typically used electrosurgical frequencies, are such that the return electrode self-limits current densities (and corresponding temperature rises) to safe thresholds, should the contact area between the patient and the electrode be reduced below otherwise desirable levels. Furthermore, self-limiting return electrodes were specifically designed to evenly distribute the current density over the entire contact area between the patient and the return electrode in order to reduce the risk of patient burns. 
     Typical self-limiting return electrodes are commonly made in multiple sizes for different sized patients. For instance, a typical self-limiting return electrode for a relatively small person (e.g., under 50 lbs.) may be about 26×12 inches while a typical self-limiting return electrode for a larger person may be about 46×20 inches. 
     As noted above, an electrical return cable connected to the return electrode provides an electrical return to the electrosurgical radio frequency energy source. However, electrical connections between the return cable and electrode, such as conventional electrical plugs or hard-wiring present a number of issues. For example, during surgery, it is not uncommon for fluids, such as bodily fluids or other fluids used by surgeons, to be present on the operating table, and thus on the return electrode. Such fluids can flow into the connection between the return electrode and cable and short-circuit the surgical system. Thus, typical connections can provide safety hazards to the patients and medical personnel in contact with the return electrode during use. The flow of fluids into the connection can also cause damage to the surgical system. Over time, the electrical connection between the return electrode and cable may corrode or wear down until it is ineffective and in need of replacement. 
     In addition to the foregoing drawbacks of conventional electrical connections, electrical plugs or hard-wired connections are not adaptable to different surgical scenarios and configurations within an operating room. Often, return electrodes are configured such that a patient must lay on the return electrode in a certain orientation. The position of the connection is thus predetermined on the table, relative to the patient. However, depending on other equipment and instruments used in the operating room, and the positions taken by surgeons and other medical professionals during an operation, the placement of the connection and corresponding return cable may be inconvenient. 
     Furthermore, return electrodes used in the electrosurgical system that include plugs or other hard-wired connections with return cables may be cleaned and/or sterilized between patient uses. In such reusable configurations, conventional plugs and wiring connections may present recessed geometries and hard-to-reach features that may be difficult to effectively clean or disinfect using wipes or other common disinfecting techniques. The difficulty of disinfecting such plugs and connections can lead to higher risk of infection for patients and medical personnel as the return electrode is repeatedly used. 
     Thus, although various advances have been made in the electrosurgical arts, there remains room for improvement. More particularly, while systems and devices have been developed to increase the safety of patients undergoing electrosurgical procedures, such as by reducing the number of patient return electrode burns, the versatility and integration of return electrodes within an operating environment has remained an issue. 
     Therefore, it would be an advance in the present electrosurgical art to provide connection systems between return electrodes and return cables that solve the problems encountered in the art, as noted above. 
     BRIEF SUMMARY 
     The present disclosure addresses the foregoing shortcomings by providing electrical connections for use with return electrodes used in electrosurgical systems that improve safety, reduce the risk of infection, and improve operating room integration. For example, in one embodiment of the present disclosure, an electrosurgical system includes a return electrode and a return conductor. The return electrode includes a conductive element and the return conductor forms a capacitive electrical connection with the conductive element. 
     In one embodiment, an electrosurgical system comprises an electrical power generator, a surgical electrode connected to the electrical power generator, and a return electrode. The surgical electrode is electrically connectable to the electrical power generator and the return electrode includes a conductive element. The return electrode is configured to draw electrical current from the surgical electrode. The electrosurgical system also includes a return cable configured to carry electrical current from the return electrode to the electrical power generator or a common ground and a return conductor forming a capacitive connection between the return cable and the return electrode. 
     In one embodiment, an electrosurgical system includes a return electrode and a return conductor. The return electrode includes an upper pad, a lower pad, and a conductive element disposed between the upper and lower pads. The upper and lower pads extend beyond an outer perimeter of the conductive element such that the conductive element is completely encompassed by the pads. The return conductor includes a conductive plate. The return conductor is configured to be removably secured to the return electrode such that the conductive plate is capacitively connected to the conductive element of the return electrode. 
     In one embodiment, according to the present disclosure, an electrosurgical return electrode includes a conductive element completely encompassed by one or more pads such that no portion of the conductive element is exposed. 
     Additional features and advantages of the disclosed embodiments will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by the practice of the disclosure. These and other features will become more fully apparent from the following description and appended claims or may be learned by the practice of the present disclosure. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       To further clarify the above and other advantages and features of the present disclosure, a more particular description will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. It is appreciated that these drawings depict only illustrated embodiments of the disclosure and are therefore not to be considered limiting of its scope. The disclosure will be described and explained with additional specificity and detail through the use of the accompanying drawings in which: 
         FIG. 1  illustrates an electrical schematic diagram of an embodiment of an electrosurgical system, according to the present disclosure; 
         FIG. 2  illustrates an embodiment of an electrosurgical system, according to the present disclosure; 
         FIG. 3  illustrates an embodiment of a return electrode disposed on an operating table, according to the present disclosure; 
         FIG. 4  illustrates a partial cross-sectional view of the return electrode illustrated in  FIG. 3 , according to the present disclosure; 
         FIG. 5  illustrates an embodiment of a return electrode on an operating table, according to an embodiment of the present disclosure; 
         FIG. 6  illustrates a cross-sectional view of the return electrode illustrated in  FIG. 5 ; 
         FIG. 7  illustrates an exploded view thereof; 
         FIG. 8  illustrates an embodiment of a return conductor forming a capacitive connection with a return electrode, according to the present disclosure; 
         FIG. 9A  illustrates an embodiment of a return conductor forming a capacitive connection with a return electrode, according to the present disclosure; 
         FIG. 9B  illustrates various views of the return conductor illustrated in  FIG. 9A ; 
         FIG. 9C  illustrates an exploded view of one element of the return conductor illustrated in  FIG. 9B ; 
         FIG. 9D  illustrates an exploded view of another element of the return conductor illustrated in  FIG. 9B ; 
         FIG. 10A  illustrates an embodiment of a return conductor forming a capacitive connection with a return electrode, according to the present disclosure; 
         FIG. 10B  illustrates an embodiment of a return conductor forming a capacitive connection with a return electrode, according to the present disclosure; 
         FIG. 11  illustrates an embodiment of a return conductor forming a capacitive connection with a return electrode, according to the present disclosure; 
         FIG. 12  illustrates an embodiment of a return conductor forming a capacitive connection with a return electrode, according to the present disclosure; 
         FIG. 13A  illustrates an embodiment of a return conductor forming a capacitive connection with a return electrode, according to the present disclosure; 
         FIG. 13B  illustrates an embodiment of the return electrode illustrated in  FIG. 13A ; 
         FIG. 13C  illustrates an embodiment of a return electrode, according to the present disclosure; 
         FIG. 14A  illustrates an embodiment of a return conductor disposed between a return electrode and an operating table, according to the present disclosure; 
         FIG. 14B  illustrates an embodiment of a return conductor disposed between a return electrode and an operating table, according to the present disclosure; 
         FIG. 15  illustrates an embodiment of a return conductor formed with an operating table and a return electrode placed thereon, according to the present disclosure; 
         FIG. 16A  illustrates an embodiment of a return conductor forming a capacitive connection with a return electrode, according to the present disclosure; 
         FIG. 16B  illustrates a cross-sectional view thereof; 
         FIG. 17A  illustrates an embodiment of a return electrode and a return conductor secured thereto, according to the present disclosure; and 
         FIG. 17B  illustrates a partial cross-sectional view thereof. 
     
    
    
     DETAILED DESCRIPTION 
     The present disclosure relates generally to electrosurgical systems. In particular, the present disclosure relates to connections for electrical return cables for electrosurgical return electrodes. The return cable connections of the present disclosure improve safety by eliminating the risk of liquids disrupting the connection and short-circuiting the electrosurgical system. In addition, the connections of the present disclosure can be used with return electrodes that do not include plugs or other electrical connection features that are difficult to clean or sterilize. As such, connections of the present disclosure reduce the risk of infection from repeated use of the return electrode and return cable connection. 
     Furthermore, connections of the present disclosure are repositionable so that medical personnel can arrange the connection to accommodate the size or surgical needs of a patient lying on a return electrode and/or other medical systems and components within an operating room. This repositionability allows medical professionals and other medical device systems to be positioned in ideal locations for a given surgery without worrying about tripping over or unintentionally disconnecting the return cable during operations. 
       FIGS. 1-5  and the corresponding discussion relate to the general structures and features of electrosurgical return electrodes that provide self-limiting characteristics and that can be used with patients of substantially any size. Turning to the drawings, and more particularly to  FIGS. 1-3 , a general discussion of self-limiting return electrodes and the general principles by which they operate will be provided.  FIG. 1  thereof depicts a simplified electrical schematic diagram of an electrosurgical system illustrating typical impedances effectively included in the operative path of radio frequency current flow as presented to an electrosurgical generator during an operative procedure. There, it will be seen is conventional radio frequency electrical power generator  100 , such as but not limited to constant power, voltage, and/or current or variable power, voltage and/or current generators. 
     Connected to electrical power generator  100  are conventional electrical conductors  102  and  104  which respectively connect generator  100  to the surgeon&#39;s implement represented by impedance z 1  and an electrosurgical return electrode represented by impedance z 3 . Impedance z 2  is provided to represent the impedance presented by the patient&#39;s tissue lying between the operation site and the return electrode. Electrical conductors  102  and  104  are representative of one illustrative structure that is capable of performing the function of connecting means for making electrical connection to the return electrode. It may be appreciated by one skilled in the art, however, that various other structures are appropriate and capable of performing the desired function. 
     Although the diagram of  FIG. 1  is simplified and generally considers circuit elements in terms of the principal resistances, including the reactance contributed by the surgical instrument, the patient&#39;s body and the return electrode, so as to clearly and succinctly illustrate principles of the disclosure, it should be understood that in reality certain other parameters would be encountered, parameters such as distributed inductance and distributed capacitance which, for purposes of clarity in illustration of the principles hereof, are deemed relatively small and so not considered at this point in this description. 
     However, as set forth below, in one embodiment when an insulating sleeve is interposed between the electrode and the body of a patient, a significant element of capacitive reactance may be included in the impedance of z 3 . It should also be noted that the Figures are intentionally simplified so as to present the principles of the disclosure succinctly. 
       FIG. 2  illustrates a practical application of the electrical schematic diagram illustrated in  FIG. 1  in the form of an electrosurgical system  101 . In  FIG. 2 , a patient  106  lies on a return electrode  108  during an operation in which a hand-held surgical electrode  110  is in contact with the patient  106 . The electrical power generator  100  powers the surgical electrode  110  via power cable  112 . During use, current flows from the electrical power generator  100  to the surgical electrode  110  and into the patient  106 . The electrical current flows through the patient  106 , into the return electrode  108  and then back to the electrical power generator  100 , or common ground thereof, via return cable  114 . 
     With reference back to  FIG. 1 , power cable  112  of  FIG. 2  is analogous to conductor  102  and return cable  114  is analogous to conductor  104 . In addition, as noted above, surgical electrode  110  is represented by impedance z 1  of  FIG. 1  and return electrode  108  is represented by impedance z 3 . Patient  106  is represented by impedance z 2 . 
     Reference is now made to  FIGS. 3-4 , which illustrate an embodiment of an electrosurgical return electrode  132  according to the present disclosure. In  FIG. 3 , electrosurgical return electrode  132  is shown in perspective on operating table  130  with electrosurgical return electrode  132  according to the present disclosure disposed on the upper surface thereof, an edge of table  130  being identified by reference number  134 . Operating table  130  is shown to have conventional legs  136   a - 136   d  that may be fitted with wheels or rollers as shown. 
     Table  130  is one structure that is capable of performing the function of supporting means for supporting a patient during treatment. It may be appreciated by one skilled in the art, however, that various other configurations of support means are possible and capable of performing the required function. For example, supporting means may include but not be limited to chairs, plates, beds, carts, and the like. 
     Although, in  FIG. 3 , the entire upper surface of table  130  is shown as being covered with return electrode  132 , it should be understood that entire coverage is by no means required in order to practice the principles of the disclosure. Thus, when used with conventional electrosurgical generators, the return electrode needs only to present an effective working surface area which is sufficient to provide adequate resistive, capacitive, or inductive coupling at the typically employed RF frequencies so as not to interfere with the surgeon&#39;s ability to perform surgery while at the same time avoiding undesired tissue damage. It has been found that at conventional electrosurgical frequencies, this has necessitated only an effective working surface area no larger than about the projected outline of one-third of the torso for an adult patient lying on an operating table or a portion of the buttocks of a patient sitting in a chair. 
     However, the effective working surface area will vary depending on the material used, in some geometrical configurations, and in instances where various layers of operating room linens are placed over the electrode. The principles hereof may be successfully employed, and the effective working surface area of the return electrode determined in such circumstances, by routine experimentation. Under certain conditions, the effective working surface may be as small as about seven square inches (or about 45 square centimeters). 
     The surface of return electrode  132  is preferably smooth and homogeneous and includes a thin resistive and/or dielectric layer. Alternatively, the surface of return electrode  132  may include a capacitive and/or inductive layer, depending on the particular operation of return electrode  132 . The characteristics of the desired dielectric for the present embodiment are sufficiently comparable to those of selected rubbers, plastics and other related materials that the latter may be satisfactorily employed as materials for the return electrode. 
     As mentioned above, with such a return electrode, if the patient is positioned such that not enough of the return electrode is in close proximity to the patient to result in as low impedance as needed, the results would be that the current flow from the electrosurgical generator would be reduced to a level making it difficult for the surgeon to perform surgery. Thus, in the present embodiment, notwithstanding interposition of some additional capacitance represented by a surgical gown, the features described above will continue to occur. 
     It will be observed that when return electrode  132  is laid out on operating table  130 , the upper exposed, or working, surface of the electrode again is expansive so as to provide low impedance. Although it is not necessary that the electrode cover the entire surface of an operating table or the entire seat surface of a dental or other patient chair, it has been found advantageous in some instances to provide a greater surface area than that of the projected area of a portion of the buttocks or torso of a patient so that if a patient position shifts during the course of a procedure, a sufficient portion of the patient will remain in registration with the electrode surface so that the effective impedance will remain less than the above-described level. 
       FIG. 3  also illustrates that return electrode  132  includes an area  139 . Area  139  of return electrode  132  may be adapted to have smaller patients positioned thereon. For instance, area  139  may be sized to have an infant sized patient positioned thereon. Furthermore, as discussed in greater detail below, return electrode  132 , and particularly area  139  thereof, may be configured to provide the self-limiting characteristics discussed herein for infant sized patients positioned on area  139 . 
     Although not illustrated, return electrode may also include additional areas configured to provide self-limiting characteristics for patients from different industry standard weight categories. By way of non-limiting example, area  139  may be configured to provide self-limiting characteristics for patients under 5 kg, a second area may be configured to provide self-limiting characteristics for patients between 5 kg and 15 kg, and a third area may be configured to provide self-limiting characteristics for patients over 15 kg. In some embodiments the areas for different sized patients may overlap one another, while in other embodiments the areas do not overlap. Furthermore, the areas may be formed concentrically with one another. 
     Regardless of the specific arrangement of areas for different sized patients (e.g., non-overlapping, overlapping, concentric, etc.) return electrode  132  may include one or more visual indicators to identify the areas for different sized patients. For instance, area  139  may include a visual indicator that identifies area  139  as suitable for patients under 5 kg. Similarly, a second area may include a visual indicator that identifies the second area as suitable for patients between 5 kg and 15 kg, and a third area may include a visual indicator that identifies the third area as suitable for patients over 15 kg. 
     The one or more visual indicators may include labels, outlines, pictures, or other indicia that are printed or otherwise displayed on the outside surface(s) of return electrode  132 . The one or more visual indicators may also or alternatively take the form of color coding. For example, each area of return electrode  132  may have a different color. The colors may be printed on return electrode  132  or the colors may be integrated into other components of return electrode  132 . For instance, one or more components within area  139  may have a first color while one or more components in the other area(s) may have different colors so that the areas are distinguishable from one another. 
     Attention is now directed to  FIG. 4 , which illustrates a simplified, partial section taken along the lines  4 - 4  of  FIG. 3 . As illustrated in  FIG. 4 , return electrode  132  includes a conductive element  140  and non-conductive or insulative pads  142 ,  144  on opposing sides of conductive element  140 . Conductive element  140 , in one configuration, is made of a conductive fabric, plastic, rubber or other flexible material. 
     In some embodiments, the one or more non-conductive or insulative pads  140 ,  142  may result in an effective DC resistance presented by each square centimeter of working surface to be greater than about 8000Ω or alternatively provide a bulk impedance of greater than 4000 Ωcm. Various materials may be appropriate for use as the non-conductive or insulative pads  142 ,  144  to give the required impedance. For example, silicone, butyl rubber, or urethane have been found to be particularly attractive materials for the non-conductive or insulative pads  142 ,  144  as they are flexible, as well as readily washable, disinfectable, and sterilizable. Alternatively, in another embodiment, the outer pads of the return electrode may be made of an inherently relatively high resistance flexible material altered to provide the requisite conductivity. One example of the latter is that of silicone rubber material in which there are impregnated conductive fibers, such as carbon black, quantities of gold, silver, nickel, copper, steel, iron, stainless steel, brass, aluminum, or other conductors. 
     In some embodiments, conductive element  140  may be fabricated from a material that is substantially transparent to one or more wavelengths of electromagnetic radiation, such as but not limited to, microwave radiation, infra-red (IR) radiation, ultraviolet (UV) radiation, X-ray radiation, radio frequency (RF), and the like. This allows conductive element  140  and return electrode  132 , when the other components of return electrode  132  are transparent to one or more wavelengths of electromagnetic radiation, to be maintained in place during performance of certain medical procedures using particular wavelengths of electromagnetic radiation. 
     It may be appreciated by one skilled in the art that conductive element  140  may have various other configurations so long as conductive element  140  is capable of performing the functions of an electrode, i.e., being capable of passing current therethrough. For example, in some embodiments, conductive element  140  includes a thin, highly conductive lower stratum that facilitates connection of return electrode  132  to an electrosurgical radio frequency energy source (not shown). In another alternate embodiment, conductive element  140  is configured from multiple layers of conductors. In still yet another embodiment, conductive element  140  includes an outer dielectric layer that substantially surrounds an interior-conducting layer, similar to the self-limiting electrosurgical electrodes described previously. 
     Referring still to  FIG. 4 , disposed on opposing sides of conductive element  140  are pads  142 ,  144 . As can be seen, pad  142  has an outer surface  146  and an inner surface  148 . Outer surface  146  is configured to be placed against the surface of a patient (thereby acting as a working surface of return electrode  132 ), while inner surface  148  is disposed next to conductive element  140 . In some embodiments, inner surface  148  is secured to conductive element  140 , such as with an adhesive, to prevent air bubbles or separation between pad  142  and conductive element  140 . Pad  142  may include outer and inner cover layers that are formed individually and secured together about their edges or are integrally formed. The outer and inner cover layers may define outer and inner surfaces  146 ,  148 . Outer and inner cover layers may be formed of various materials, such as urethane, polyurethane, polyethylene, polypropylene, polyolefins, polyvinyl chloride, PET, etc. A fill material, discussed below, may be disposed between the outer and inner cover layers. 
     Similar to pad  142 , pad  144  includes an outer surface  154  and an inner surface  156 . Outer surface  154  is configured to be placed on a support surface (e.g., operating table, chair, etc.), while inner surface  156  is disposed next to conductive element  140 . Like outer and inner cover layers  146 ,  148 , one or both of outer surface  154  and inner surface  156  may be defined by a cover layer formed of various materials, such as urethane, polyurethane, polyethylene, polypropylene, polyolefins, polyvinyl chloride, PET, etc. Like pad  142 , inner surface  156  may be secured to conductive element  140 , such as with an adhesive, to prevent air bubbles or separation between pad  144  and conductive element  140 . In other embodiments, however, the edges of pad  144  may be secured to the edges of pad  142  with conductive element  140  disposed therebetween. Also, like pad  142 , pad  144  may include a fill material. 
     Fill materials used in pads  142 ,  144  may provide return electrode  132  with some pressure reducing characteristics. More specifically, since pads  142 ,  144  retain a defined volume of fill material, when an individual rests upon return electrode  132 , the fill materials distribute the downward force of the patient throughout the fill materials, thereby decreasing the point forces applied to those parts of the patient&#39;s anatomy where bony prominences or other areas of increased pressure are located. Nevertheless, as discussed elsewhere herein, pads  142 ,  144  are relatively thin to ensure sufficient coupling between a patient and conductive element  140 . Accordingly, in some situations, such as during lengthy surgical procedures, it may be desirable or necessary to use a separate pressure reducing pad in combination with return electrode  132  to prevent the formation of pressure sores on the patient or to increase the patient&#39;s comfort level. 
     Fill materials used in pads  142 ,  144  may act as dielectric layers to reduce the current that flows through pads  142 ,  144 , respectively. Alternatively, the fill materials may take the form of conducting materials to aid with the transmission of current therethrough. Additionally, the fill materials may provide a thermal mass for the distribution of heat during an electrosurgical procedure. As discussed above, IEC requires that during an electrosurgical procedure the temperature rise of the patient&#39;s tissue should remain below six degrees Celsius (6° C.). The thermal mass provided by the fill materials assists with the distribution of heat throughout the patient&#39;s body and substantially eliminates, in combination with the self-limiting characteristics of return electrode  132 , the potential for hot spots that may burn the patient. Consequently, the substances used for fill materials may perform multiple functions during an electrosurgical procedure. 
     In general, the fill materials may take the form of one or more solids, liquids, gases, or combinations thereof depending on the pressure reducing, dielectric, and/or conducting properties needed for return electrode  132 . For example, in one illustrative embodiment, the fill materials are elastomeric gels having low durometer level, such as SORBOTHANE. In addition to SORBOTHANE, various other elastomeric gels may be used, such as but not limited to those based upon the polymer chemistry of urethanes, silicones, hydrophilic elastomers or hydrogels, vinyls, vinyl alcohols, or other similar materials and technologies. Additionally, the fill materials may take the form of water, saline, water-based materials, conductive oils, and the like. Still further, the fill materials may take the form of solid but flexible foam-type materials. 
     The materials forming return electrode  132 , conductive element  140 , and pads  142 ,  144 , at least partially control the passage of current from a patient to conductive element  140 . As such, in one embodiment, pads  142 ,  144  are insulative. In an alternate configuration, pads  142 ,  144  may be conductive and aid in the passage of current from the patient to conductive element  140 . So long as the return electrode  132  provides the self-limiting characteristics described herein, the various elements of return electrode  132 , i.e., conductive element  140  and pads  142 ,  144 , may provide one or more resistive, inductive, and/or capacitive inductance components to the bulk impedance of the return electrode. In this manner return electrode  132  is self-limiting, while also providing at least some pressure reducing characteristics. 
     In addition to the materials used to form pads  142 ,  144 , the thickness and arrangement of pads  142 ,  144  and conductive element  140  can affect the transmission of current from a patient to conductive element  140 . By way of non-limiting example, the distance between outer surface  146  of pad  142  and conductive element  140  can affect the capacitive coupling between conductive element  140  and a patient resting upon return electrode  132 . Through this capacitive coupling, current used during electrosurgery is passed from the patient to return electrode  132 . As will be understood by one of ordinary skill in the art in light of the disclosure herein, the capacitive coupling between the patient and return electrode  132  can be directly related to the self-limiting characteristics of return electrode  132 . Thus, by changing the distance between the outer surface  146  and the conductive element  140 , the capacitive coupling between the patient and the return electrode  132  can be adjusted. 
     Note that the return electrode  132  shown in  FIG. 3  does not include a conventional electrical connection, such as a hard-wired connection or plug anywhere on the return electrode  132 . The various embodiments of return electrodes  132  described herein are configured such that no external plug or hard-wired electrical connection is necessary. Advantageously, such configurations allow medical personnel to arrange and position the return electrode  132  anywhere within an operating room, regardless of where an electrical outlet or other power source, such as the electrical power generator  100 , may be located. 
     For example, with traditional return electrodes having external plugs or other hard-wired, exposed conductive connections, the return electrode plug must be situated within the operating room in a convenient position relative to the energy source, such that a conductive cord can reach between the energy source and the return electrode plug without obstructing medical personnel or other medical system during an operation. Thus, external plugs and other hard-wired conductive connections limit the orientations available when setting up the return electrode on an operating table for patient use. The available orientations of return electrodes having external plugs are further limited by the presence of other medical devices and systems connected to the patient, positioned around the operating table, or being used by a doctor or nurse, which conductive cords and energy sources must also accommodate. 
     In addition to integrating return electrodes having external plugs into existing operating rooms having other devices and systems, other factors further complicate the integration and use of return electrodes having external plugs or other hard-wired conductive connections. For example, medical personnel must take precautions to orient return electrodes having external plugs so that the plug is not in contact with the patient during use, which could cause electrical current to flow back into the patient, causing injury and reducing the effectiveness of the surgical system. Also, for example, medical personnel must take precautions so that the position of the external plug minimizes the chance of fluids entering the plug and disrupting the electrical circuit of the surgical system. All of these factors make it difficult to ensure safe and convenient use of return electrodes having external plugs. 
     In contrast, and advantageously, return electrodes  132  of the present disclosure eliminate the various complications presented by external electrical plugs and other exposed conductive connections by eliminating any external plugs altogether. That is, as shown in  FIGS. 3 and 5 , as well as subsequent figures described herein, the return electrode  132 ,  180  includes no such external plugs. Rather, the return electrodes  132 ,  180  of the present disclosure can be oriented and arranged in any configuration within an operating room and underneath a patient without moving the position of the electrical connection between the conductive element  140  and a return cable  114 . In order to accomplish the foregoing, at least one embodiment of an electrosurgical system comprises a reconfigurable capacitive electrical connection between the conductive element  140  of the return electrode  132 ,  180  and the return cable  114 . The capacitive connection can occur anywhere on the return electrode regardless of the position and orientation of the return electrode  132 ,  180  on the operating table, in an operating room, or relative to a patient. 
     More detail regarding various embodiments of such capacitive connections and apparatus will be given hereafter but first attention is directed to  FIGS. 5-7 , which illustrate an electrosurgical return electrode  180  without externally exposed electrical plugs, according to an embodiment of the present disclosure.  FIG. 5  illustrates return electrode  180  on operating table  130 . Similar to return electrode  132 , return electrode  180  does not include an exposed electrical connection to provide a conventional electrical return to the electrosurgical radio frequency energy source. Rather, in at least one embodiment, the outer layers  182  of the return electrode  180  completely encompass a conductive element disposed completely within the return electrode  180  so that no portion of the conductive element is accessible from outside the return electrode  180 . 
     In such an embodiment, the return electrode  180  includes a simplified geometry without hard-to-reach contours and recesses of an externally exposed electrical plug or other common conductive connection. This is advantageous when cleaning and/or sterilizing the return electrode  180  between patient uses to reduce the risk of infections. For example, typical return electrodes include a conductive connection or plug in communication with the conductive element inside the return electrode. During sterilization with wipes or other common sterilization techniques, it is difficult for medical personnel to reach the inside contours and crevasses of the electrical connection. As such, bacteria is prone to remain within the connection. In contrast, the return electrodes  132 ,  180  of the present disclosure do not include such common connections. As a result, the return electrode  180  can more easily be thoroughly wiped and sterilized between uses, reducing risk of infection to the patients laying thereon. 
     In addition, the material of the conductive element inside the return electrode  180  is not exposed in any way to be corroded, damaged, or otherwise harmed when shipped, moved, stored, and used. No electrical connection is present to break or corrode. Also, the return electrode may be freely folded, rolled, or otherwise packaged and stored in any number of ways without rigid or bulky electrical connections getting in the way or complicating packaging or storing processes. 
     To illustrate the construction of at least one embodiment of the return electrode  180 , including the conductive element disposed therein,  FIG. 6  illustrates a simplified section taken along the lines  6 - 6  of  FIG. 5  and  FIG. 7  illustrates an exploded view of return electrode  180 . As illustrated in  FIGS. 6 and 7 , return electrode  180  includes a conductive element  184  and pads  186 ,  188  on opposing sides of conductive element  184 . Pads  186 ,  188  may be referred to individually as upper pad  186  and lower pad  188 . However, as will be clear from subsequent descriptions and figures, either pad  186 ,  188  may be oriented above or below the conductive element  140  during use while maintaining the functionality of the return electrode  180 . Indeed, at least one advantage of the return electrode  180  is that medical personnel can place the return electrode  180  in any orientation on the operating table  130  without losing functionality provided by the return electrode. That is, the return electrode  180  may be placed on the operating table  130  with either pad  186  or pad  188  facing up and upon which a patient may rest. 
     Conductive element  184 , in one configuration, may be similar to conductive element  140 . Nevertheless, it may be appreciated by one skilled in the art that conductive element  184  may have various other configurations so long as conductive element  184  is capable of performing the functions of an electrode, i.e., being capable of passing current therethrough. 
     Referring still to  FIGS. 6 and 7 , disposed on opposing sides of conductive element  184  are pads  186 ,  188 . As can be seen, pad  186  has an outer cover layer  190  and an inner cover layer  192  that define an interior chamber  194  therebetween. Outer cover layer  190  is configured to be placed against the surface of a patient (thereby acting as a working surface of return electrode  180 ), while inner cover layer  192  is disposed next to conductive element  184 . In some embodiments, inner cover layer  192  is secured to conductive element  184 , such as with an adhesive, to prevent air bubbles or separation between pad  186  and conductive element  184 . Outer and inner cover layers  190 ,  192  may be formed individually and secured together about their edges or may be integrally formed. Outer and inner cover layers  190 ,  192  may be formed of various materials, such as urethane, polyurethane, polyethylene, polypropylene, polyolefins, polyvinyl chloride, PET, etc. A fill material  196 , similar to that discussed elsewhere herein, may be disposed in interior chamber  194 . 
     Similar to pad  186 , pad  188  includes an outer cover layer  198  and a fill material  200 . Outer cover layer  198  is configured to be placed against the surface of a patient (thereby acting as a second working surface of return electrode  180 ), while fill material  200  is disposed next to conductive element  184 . Like outer and inner cover layers  190 ,  192 , outer cover layer  198  may be formed of various materials, such as urethane, polyurethane, polyethylene, polypropylene, polyolefins, polyvinyl chloride, PET, etc. 
     Rather than having a second inner cover layer, pad  188  may be formed during the assembly of return electrode  180 . For instance, during assembly of return electrode  180 , chamber  194  in pad  186  may be filled with material  196  and sealed closed such that material  196  cannot escape from chamber  194 . Pad  186  may be disposed next to and/or secured to a first major surface of conductive element  184 . The edges of outer cover layer  198  may then be secured to the edges of pad  186  so as to create a chamber between conductive element  184  and outer cover layer  198 . The newly defined chamber may then be filled with material  200  and sealed closed to retain material  200  therein. 
     It will be appreciated that pads  186 ,  188  may be similar or identical to one another. For instance, in addition to outer cover layer  198  and material  200 , pad  188  may also include an inner cover layer (similar to inner cover layer  192 ) that cooperates with outer cover layer  198  to define a chamber for receiving material  200 . Furthermore, pad  188  may also be at least partially secured to conductive element  184 . For instance, in embodiments where pad  188  includes an inner cover layer, the inner cover layer may be secured, such as with an adhesive, to a second major surface of conductive element  184 . 
     Likewise, pad  186  may be similar to pad  188  in that pad  186  may be formed without inner cover layer  192 . In such an embodiment, the outer layer  190  of pad  186  may be secured to outer layer  198  of pad  188 . Additionally, or alternatively, in at least one embodiment, each outer layer  190 ,  198  may at least partially secure to the conductive element  184 , for example at an outer edge thereof, as well as to the opposing outer layer  190 ,  198 . 
     In any case, one will appreciate that the conductive element  184  of the return electrode  180  is completely encompassed by the surrounding pads  186 ,  188  so that the conductive element  184  is not exteriorly exposed in any way, as shown in the embodiments of return electrodes  132 ,  180  illustrated in  FIGS. 3 and 5 . 
     While  FIG. 6  illustrates a cross-sectional view of the return electrode  180  taken along lines  6 - 6  in  FIG. 5 , the cross-sectional view of the return electrode  180  would look similar regardless of the orientation of the line  6 - 6 , whether it be longitudinal, lateral, or diagonally disposed across the return electrode  180 . That is, the pads  186 ,  188  extend beyond the outer edges of the conductive element  184  around the entire perimeter of the return electrode  180  so that the conductive element is disposed within, and completely encompassed by, the pads  186 ,  188 . 
     In at least one embodiment, the pads  186 ,  188  are welded, adhered, sealed, or otherwise formed together at a pad juncture  187  around the outer perimeter of the conductive element  140 . In at least one embodiment, the pads  186 ,  188  are integrally formed together as a single piece. In any case, as noted above, the conductive element  184  is completely surrounded and encompassed by the pads  186 ,  188  so that no portion of the conductive element  184  is exposed or extending beyond the pads  186 ,  188 . Furthermore, as noted above with reference to  FIG. 3 , there is no conductive electrical plug or any other external conductive electrical connection that passes through the pad juncture  187  at any point around the perimeter of the return electrode  180  to make conductive electrical contact with the conductive element  184 . The conductive element  184  is thus completely isolated from the environment outside of the pads  186 ,  188 . 
     The materials forming return electrode  180 , conductive element  184 , and pads  186 ,  188 , control the passage of current from a patient to conductive element  184 . As such, in one embodiment, pads  186 ,  188  and fill materials  196 ,  200  are insulative, while, in an alternate configuration, pads  186 ,  188  and/or materials  196 ,  200  may be conductive and aid in the passage of current from the patient to conductive element  184 . So long as return electrode  180  provides the self-limiting characteristics described herein, the various elements of return electrode  180 , i.e., conductive element  184  and pads  186 ,  188 , may provide one or more resistive, inductive, and/or capacitive inductance components to the bulk impedance. 
     In addition to the materials used to form pads  186 ,  188 , the thickness of pads  186 ,  188  can affect the transmission of current from a patient to conductive element  184 . By way of non-limiting example, forming pads  186 ,  188  relatively thin can facilitate capacitive coupling between conductive element  184  and a patient resting upon return electrode  180 . Through this capacitive coupling, current used during electrosurgery is passed from the patient to return electrode  180 . As will be understood by one of ordinary skill in the art in light of the present disclosure, the capacitive coupling between the patient and return electrode  180  can be directly related to the self-limiting characteristics of return electrode  180 . Thus, making pads  186 ,  188  relatively thin contributes to good electrical coupling between the patient and return electrode  180  so as to enable safe and effective electrosurgery for substantially any sized patient. Accordingly, one or both of pads  186 ,  188  may have a thickness within a predetermined range. 
     For instance, in some embodiments, one or both of pads  186 ,  188  has an approximate thickness of between about 0.02 inches and about 0.120 inches. In other embodiments, one or both of pads  186 ,  188  has an approximate thickness of less than about 0.10 inches, about 0.09 inches, about 0.075 inches, about 0.06 inches, about 0.05 inches, about 0.03 inches, or about 0.02 inches. In some embodiments, return electrode  180  has a total thickness of about 0.135 inches or less. 
     The inclusion of pads  186 ,  188 , which are substantially similar to one another, on opposing sides of conductive element  184  provides return electrode  180  with a substantially symmetrical construction. The symmetrical nature of return electrode  180  provides return electrode  180  with two surfaces that function as working surfaces. More specifically, the major surfaces of return electrode  180  defined by outer cover layers  190 ,  198  may each be used as a working surface. For instance, return electrode may be positioned so that outer cover layer  192  is positioned towards a patient and return electrode  180  will exhibit the self-limiting characteristics discussed herein. Likewise, return electrode  180  can be turned over so that outer cover layer  198  is positioned against a patient and return electrode  180  will exhibit the self-limiting characteristics discussed herein. 
     As noted above with reference to  FIG. 2 , a return cable  114  may be connected to the return electrode  180  to carry electrical current back to the electrical power generator  100 , thus drawing current out from the patient via the return electrode  180 . Accordingly, electrosurgical systems incorporating the various embodiments of return electrodes  132 ,  180  described herein may employ one or more capacitive electrical connections that allow current to be induced by capacitive coupling across the pads  186 ,  188  surrounding the conductive element  184 , or any other materials separating the conductive element  184  from the return cable  114 . 
     For example, as shown in  FIG. 8 , a return conductor  202  may be placed against the lower pad  188  of return electrode  180  such that it is brought into close enough proximity to the conductive element  184  of the return electrode  180  to form a capacitive connection therebetween. The return conductor  202  may be connected to the lower pad  188  so that current in conductive element  184  induces current in the return conductor  202 , which flows to the electrical power generator  100  via the return cable  114 , which is connected to the return conductor  202 . 
     One will appreciate that the materials separating the conductive element  184  of the return electrode  180  and the return conductor  202  may vary between embodiments described herein and will affect the inducement of current by the conductive element  184  in the return conductor  202 . In addition, some materials, as well as the thicknesses of material layers between conductive elements  184 ,  202  may present unique properties that operate as dielectric materials between the conductive element  184  and return conductor  202 . 
     Such materials and thicknesses described herein may present unique filtering effects, such as high-frequency, low-frequency, or band-pass filtering of frequencies generated by the electrical power generator  100  for use with the hand-held surgical electrode  110 . Because the frequencies used during an operation may vary depending on the type of operation and/or specific electrode used, the materials separating the conductive element  184  and return conductor  202  can be specifically designed to provide sufficient capacitive coupling and current generation by conductive element  184  in return conductor  202 . 
     In some embodiments, materials separating the conductive element  184  and return conductor  202  may include, for example, materials coating or surrounding the exterior conductive element  202 . 
     The various embodiments of return conductors  202  described herein, including the return conductor illustrated in  FIG. 8  and subsequent figures, are configured to be removably secured to a return electrode, such as the return electrodes  132 ,  180  illustrated in  FIGS. 3 and 5  and other return electrodes described herein. When secured thereto, the return conductor  202  forms a capacitive electrical connection between the return electrode  180  and the return cable  114 . However, the various embodiments of return conductors described herein can be easily removed and re-secured or repositioned on the return electrode  180  prior to, during, or after use. As such, the removable return conductors of the present disclosure are reconfigurable to allow any number of orientations of the return electrode  180  within an operating room on the operating table  130  while still enabling the necessary capacitive connection required for current generation by the return electrode  180  in the return conductor  202 , which is then carried by the return cable  114  to the electrical power generator  101 . 
     As shown in  FIG. 9A , in at least one embodiment, a return conductor  202  may be magnetically coupled to the return electrode  180  via an opposing magnetic element  204  disposed on an opposing side of the return electrode  180 . One or more magnets may be disposed within both the return conductor  202  and the magnetic element  204  to secure the return conductor  202  to a surface of the return electrode  180 . As illustrated in  FIG. 9B , the return conductor  202  includes a conductive plate  206  disposed on a lower surface  208  of the return conductor  202 . A casing  210  may include one or more channels  212  through which wires from the return cable  114  may pass to contact the conductive plate  206 . 
     The casing  210  may also include recessed features behind the conductive plate  206  for housing one or more magnets. As noted above, the magnets disposed within the return conductor  202  attract the magnets  214  disposed within a casing  216  of the magnetic element  204  to secure the return conductor  202  to the return electrode  180 . The number, shape, and arrangement of magnets  214  within the magnetic element  204  and return conductor  202  may vary in different embodiments. The strength of attraction between the magnets in the return conductor  202  and the magnetic element  204  may determine how securely the return conductor  202  maintains a connection with the return electrode  180 . 
     In addition, the strength of the magnetic attraction between the return conductor  202  and magnetic element  204  may decrease the distance between the conductive plate  206  and the conductive element  184  within the return electrode  180 . For example, as noted above, the pads  186 ,  188  surrounding the conductive element  184  may be compressible so that a strong magnetic attraction between the return conductor  202  and magnetic element  204  cause the pads  186 ,  188  to compress, bringing the conductive plate  206  closer to the conductive element  184 . In this way, the magnets  214  may be selected and arranged within the return conductor  202  and the magnetic element  204  to optimize the distance between the conductive plate  206  and conductive element  184  based on the material properties and dimensions of the pads  186 ,  188  surrounding the conductive element  184 . 
       FIG. 9C  illustrates an exploded view of the return conductor  202 , including the casing  210 , magnets  214 , conductive plate  206 , and return cable  114 . As seen, in at least one embodiment, the casing  210  of the return conductor  202  may comprise a recessed area  218  formed on a lower side  208  of the casing  210  in which the conductive plate  206  may be disposed. In such a configuration, the conductive plate  206  may be disposed such that direct contact is made between the conductive plate  206  and the return conductor  202 . In at least one embodiment, the conductive plate  206  may be disposed within the casing  210  and thus separated from the return electrode  180  by the material of the casing  210 . 
     In addition, in at least one embodiment, the casing  210  includes one or more recessed portions  220  configured to house one or more magnets  214 . The arrangement, size, and number of recesses  220 , as well as corresponding magnets  214 , may vary in one or more other embodiments, so long as the magnets  214  disposed within the casing  210  of the return conductor  202  align sufficiently with the magnets  214  of the magnetic element  204  to secure the return conductor  202  to the return electrode  180 . 
     Along these lines,  FIG. 9D  illustrates an exploded view of the magnetic element  204 , according to an embodiment of the present disclosure. As shown, the magnetic element  204  includes a casing  216  having one or more recessed portions  222  configured to house magnets  214 . Similar to the magnets  214  and recessed portions  220  of the return conductor  202  described above, the magnets  214  and recessed portions  222  of the magnetic element  204  may vary in size, shape, and arrangement so long as they sufficiently align with the magnets of the return conductor  202  to secure the return conductor  202  to the return electrode  180 . 
     In addition, one of ordinary skill in the art will appreciate that one set of magnets  214 , either those of the return conductor  202  those of the magnetic element  204  may alternatively comprise a ferrous material, rather than magnetic material, which would be attracted by opposing magnets  214  in the return conductor  202  and/or magnetic element  204 . 
     In addition, the size, shape, materials, and configuration of the casing  210  of the return conductor  202  may vary in one or more other embodiments, so long as the return conductor  202  is magnetically attracted to the magnetic element  204  sufficiently to form a capacitive connection between the conductive element  184  inside the return electrode  180  and the conductive plate  206  to pass current into the return cable  114 . For example, in at least one embodiment, the overall shape of the casing  210  may be rectangular, triangular, polygonal, or otherwise irregularly shaped. Likewise, the conductor plate  206  may be comprised of any suitable conducting material and be rectangular, triangular, polygonal, or otherwise irregularly shaped. 
     In addition, the conductive plate  206  may form a contact area as small as ½-square inch to as large as the return conductor  202  itself. Advantageously, in the embodiments of magnetically secured return conductors  202  described herein, the return conductor  202  may be placed anywhere on the return electrode  180  so long as the return conductor  202  and magnetic element  204  directly oppose one another on opposite sides of the return electrode  180 . As such, a medical professional preparing for surgery may position the return conductor  202  on a portion of the return electrode  180  that is less likely to disrupt the operation being performed or contact the patient laying on the return electrode  180 . 
     In at least one embodiment, the return conductor  202  may be placed on the top surface of the return electrode  180  with the opposing magnetic element  204  disposed on the bottom surface thereof. Alternatively, the return conductor  202  can be placed on the bottom surface of the return electrode  180  with the magnetic element  204  on the top surface thereof. While  FIG. 9A  illustrates the return conductor  202  placed near an edge of the return electrode  180 , the return conductor can be placed at a location anywhere on the return electrode  180 . 
     In addition, the return conductor  202  may be placed on the return electrode  180  such that the position of the return cable  114  extending therefrom does not get in the way of other devices or medical personnel during an operation. In this way, the magnetically secured return conductor  202  improves operating room integration. Additionally, the capacitive connection between the return conductor  202  and conductive element  184  can still operate under wet conditions, such as when fluids are present between the return conductor  202  and return electrode  180  during, thus reducing the risk of short-circuiting the electrosurgical system  101  and potentially harming the patient and medical personnel during use. 
     In particular, in embodiments including a conductive plate  206  disposed inside the casing  210  of the return conductor  202 , or in embodiments with conductive plates  206  otherwise coated with a non-conductive material, the conductive plate  206  does not come into contact with fluid that may be present between the return conductor  202  and return electrode  180 . In this way, no electrical/conductive elements are exposed, either from the return electrode  180  or conductor  202 , to be corroded or damaged during use, further decreasing the risk of short-circuits and/or injury. 
     The capacitive connection between the return conductor  202  and conductive element  184  of the return electrode  180  thus provides increased safety and adaptability over common electrical plugs or other hard-wired connections between typical return electrodes and return cables currently known in the art. 
     In other embodiments, one or more magnetic elements  204  or magnets may be incorporated into the return electrode  180 . For instance, one or more magnetic elements  204  or magnets may be secured in place between the pads  186 ,  188  and/or between the conductive element  184  and one or both of the pads  186 ,  188 . In some embodiments, a magnetic element  204  or magnet may be secured within the return electrode  180  near one or more corners thereof and/or at one or more locations along one or more sides thereof. The return electrode  180  may include a visual indicator to identify the location(s) of the one or more magnetic elements  204  or magnets. In some embodiments, the return conductor  202  may be connected to the return electrode  180  by positioning the return conductor  202  in close proximity to at least one of the magnetic elements  204  or magnets incorporated into the return electrode  180 . 
     Regardless of whether the magnetic element(s)  204  or magnetics are selectively attachable to the return electrode  180  (as shown in  FIG. 9A ) or incorporated into the return electrode  180  as noted above, attention should be paid to the orientation of the magnetic poles of the magnets in the return conductor  202  and the magnetic element(s)  204 . For instance, assuring that opposing poles of the magnetics in the return conductor  202  and the magnetic element(s)  204  face one another can help ensure that a secure connection therebetween can be made (e.g., without the return conductor  202  slipping to one side of the magnetic element  204 ). Additionally, or alternatively, predetermined placement (including pole orientation) of the magnetics in the return conductor  202  and the magnetic element(s)  204  may allow the return conductor  202  to spin or rotate around a predefined point without becoming disconnected from the magnetic element(s)  204 . This can allow for greater flexibility in the direction the return cable  114  extends away from the return electrode  180 . 
     In addition to the magnetically secured return conductor  202  described herein, one or more other embodiments of the present disclosure may include other types of securement means that form a capacitive connection between the conductive element  184  within the return electrode  180  and the return conductor  202 . For example, in at least one embodiment, as shown in  FIG. 10A , a return conductor  224  includes a spring-biased clip  226  that secures one or more conductive plates  228  to the return electrode  180 . 
     In general, in such an embodiment, a spring  230  interacts with two or more opposing clip members  232 ,  234  to bias those two members  232 ,  234  together around an edge of the return electrode  180 . The biasing force of the spring  230  is strong enough to secure the clip  226  to the return electrode  180 . Also, as shown in  FIG. 10A , at least one of the clip members  232 ,  234  includes a conductor plate  228  on an inner surface of the clip member  232  that is pressed against the return electrode  180  during use, thus bringing the conductor plate  228  into close proximity with the conductive element  184  inside the return electrode  180 . In at least one embodiment, both clip members  232 ,  234  include one or more conductive plates  228  disposed thereon. 
     In at least one embodiment, the return cable  114  may be electrically connected to the one or more conductive plates  118  either directly or through the clip members  232 ,  234 .  FIG. 10B  illustrates a perspective view of an embodiment of a return conductor  224  including a spring biased clip  226 . In the illustrated embodiment of  FIG. 10B , the spring biased clip  226  may take the form similar in functionality to a binder style paper clip so that a user can manipulate two or more handles  236 ,  238 , each connected to a clip member  232 ,  234 , to oppose the spring  230  while opening the clip  226  or release the clip members  232 ,  234  to be biased together during use. In this way, a medical professional can remove and reattach the return conductor  224  as needed. 
     The return conductor  224  may be clipped anywhere around the edge of the return electrode  180 , either prior to or during an operation as needed. The extent to which the conductive plates  228  extend over the return electrode  180  depend on the length of the clip members  232 ,  234  to which the conductive plates  228  are attached. 
     Alternatively, or additionally, in at least one embodiment, such as that shown in  FIG. 11 , the return conductor  224  includes a ratchet mechanism  240  that maintains a firm grip of the clip members  232 ,  234  around an edge of the return electrode  180 , thus ensuring a proper connection between the conductive plates  228  and a conductive element inside the return electrode  180 . In at least one embodiment, the ratchet mechanism  240  includes a switch  242  that operates to change the directionality of the ratchet mechanism  240 . Using the switch, a user can clamp the clip members  232 ,  234  down around the return electrode  180  or release the clip members  232 ,  234  to release the return conductor  224 . 
     In at least one embodiment, as illustrated in  FIG. 12 , a return conductor  244  may include an adhesive layer  246  disposed between the conductive plate  228 , or other material layer of the return conductor  244 , and the return electrode  180 . In such an embodiment, the return conductor  244  may be adhered anywhere on the outer surface of the return electrode  180 , either on top or bottom, to place the conductive plate  228  in close enough proximity to a conductive element inside the return electrode  180  to form a capacitive connection therebetween. 
     In at least one embodiment, the adhesive layer  246  comprises a removable adhesive, such as a pressure sensitive adhesive, or friction adhesive such as a silicone material or the like. In at least one embodiment, the adhesive layer  246  may enable a removable and reusable connection between the return conductor  244  and the return electrode  180  such that the position of the connection therebetween can be selected prior to, or during, an operation as needed based on the position of the return electrode  180  and power source  100  within a room and/or based on the size and position of the patient on the return electrode  180 . 
     In at least one embodiment, as illustrated in  FIG. 13A , a return electrode  180  may comprise a layer of hook-and-loop material  250  secured thereto that can be removably secured to an opposing, compatible portion  252  of hook-and-loop material secured to a surface of the return electrode  180 . In this way, the return conductor  248  can be secured and removed from various portions of the return electrode  180 , either a top portion, bottom portion, edge portion, or otherwise, before or during an operation, to create a capacitive connection between the return electrode  180  and the return cable  114 . 
     Accordingly, the position of the capacitive connection between such an embodiment of the return conductor  248  and the return electrode  180  depends on the placement of the opposing portion(s)  252  of the hook-and-loop material secured to the return electrode  180 . For example,  FIG. 13B  illustrates an embodiment of a return electrode  180  having portions  252  of hook-and-loop material around the perimeter edges of both the top surface  254  and bottom surface  256 . In at least one embodiment, only the top surface  254  or only the bottom surface  256  includes portions  252  of hook-and-loop material. In at least one embodiment, one or more portions  252  may be more centrally disposed on the top or bottom surface  254 ,  256  of the return electrode  180 . 
     In at least one embodiment, as illustrated in  FIG. 13C , the portion  252  of hook-and-loop material may cover the entire bottom surface  256  of the return electrode  180  while the top surface  254  is completely free of hook-and-loop portions. In such an embodiment, the return conductor  248  may be placed anywhere beneath the return electrode  180 , between the return electrode  180  and an operating table, to form the capacitive connection therebetween. One will appreciate that, while not all combinations and possible configurations of hook-and-loop portions  252  disposed on the return electrode  180  can be illustrated or described herein, the hook-and-loop portions  252  of the return electrode  180  can be strategically placed anywhere on the surface of the return electrode  180  to effectuate a capacitive connection between the return electrode  180  and the embodiment of the return conductor  248  illustrated in  FIG. 13A . 
     In at least one embodiment, as shown in  FIG. 14A , a return conductor  258  may comprise a conductive plate or pad that extends underneath the entirety of the return electrode  180  to form a capacitive connection therebetween. In the illustrated embodiment, the return conductor  258  has the same surface area as the return electrode  180 . In such an embodiment, no connection features may be required as the weight of a patient or just the weight of the return electrode  180  itself secures the return conductor  258  in place between the table  130  and the return electrode  180 . In at least one embodiment, the return conductor  258  may comprise one or more padded layers to form a pressure pad or similar pad for patient weight distribution and comfort. 
     Alternatively, as seen in  FIG. 14B , the same type of capacitive connection can be made with a pad or plate  260  (shown indicated in dotted lines underneath the return electrode  180 ) that is smaller in area than the return electrode  180 . In such an embodiment, the return conductor  260  can be placed anywhere underneath the return electrode  180  and held in place by the weight of the return electrode  180  and/or the patient. In at least one embodiment, the surface area of the return conductor  258 ,  260  is larger than the surface area of the return electrode  180 . 
     In at least one embodiment, all or a portion of the top surface  268  of the operating table  130  may comprise a return conductor  270 , as illustrated in  FIG. 15 . In at least one embodiment, the return conductor  270  may be integrally formed with the top surface  268  of the table  130  or formed to be the top surface  268  of the table  130 . In such an embodiment, the return cable  114  may be connected directly to the top surface  268  of the table  130 , through which current induced by the return electrode  180  passes. 
     In at least one embodiment, as shown in  FIG. 16A , a return conductor  262  may include an envelope into which the return electrode  180  is inserted. The return electrode  180  may be fully or partially inserted into the return conductor  262  and the envelope of the return conductor  262  may be sized to either fully or partially envelop the return electrode  180 . 
     Along these lines,  FIG. 16B  illustrates a cross-sectional view of the return electrode  180  and return conductor  262  taken along the line  15  indicated in  FIG. 16A . From the cross-sectional view of  FIG. 16B  the return conductor is shown to include an upper layer  264  and a lower layer  266  with the return electrode  180  inserted substantially fully therebetween. In at least one embodiment, not shown here, the return conductor  262  may include a cover or other closing portion to cover any exposed portion of the return electrode  180  so that the return electrode  180  is completely enveloped by the return conductor  262 . 
     In at least one embodiment, the lower layer  266  of the return conductor  262  comprises a conductive plate. The lower layer  266  may thus form a capacitive connection between the conductive element  140  within the return electrode  180  and the return cable  114  due to the proximity of the lower layer  166  and the conductive element  140 , as discussed above with reference to other embodiments. The lower layer  266  may also include one or more other padded elements or layers. The upper layer  264  may exhibit water-proof or water-resistant characteristics to shield the return electrode  180  from fluids. 
     In at least one embodiment, as shown in  FIG. 17A , the return electrode  180  may comprise one or more pockets  272   a - d  into which a return conductor  274  may be inserted, such as that shown in dotted lines inserted into pocket  272   a . The pockets  272   a - d  may be arranged in any configuration or position on the top or bottom surfaces of the return electrode  180  to accommodate the return conductor  274  in a number of convenient locations. Various embodiments of return electrodes  180  may include more or less than the four pockets  272   a - d  shown in  FIG. 17A . Along these lines,  FIG. 17B  illustrates a cross-sectional view of the return conductor  274  inserted into a pocket  272 . The pocket  272  may include any number of configurations of material extending above or below the return electrode  180  that forms an inner space  276  into which the return conductor  274  may be inserted. The pocket  272  thus holds the return conductor  274  against the return electrode  180  to establish a capacitive connection therebetween. 
     In all embodiments of return electrodes and return conductors described herein, the size and shape of the return conductors and/or corresponding conductive plates disposed may vary. For example, in at least one embodiment, a return conductor or conductive plate thereof may be as small as ½-inch by ½-inch (in the case of a rectangular shape). Alternatively, in at least one embodiment, a return conductor or conductive plate thereof may be as large or larger than the return electrode to which it is connected. 
     Also, as noted above, the various material layers separating the conductive element  140 ,  184  of the return electrode  180  and the conductive plate(s)  228  of the various return conductors, be they padded layers, conductive layers, adhesive layers, hook-and-loop layers, return conductor casing layers, or the like, may be formed to specific thicknesses and from specific materials to accommodate specific electrical frequencies produced by the electrical power generator  100  and used by the hand-held surgical electrode  110 . The thicknesses and materials of the various layers may be selected to avoid unwanted filtering of frequencies used during an operation and to effectuate successful capacitive connections between the conductive element  140 ,  184  of the return electrodes and the conductive plates  206 ,  228  of the return conductors. 
     The various embodiments of return conductors and/or return cables described herein may include one or more switching features that communicate with the electrical power generator  100 . For example, in at least one embodiment, a return conductor (as seen throughout the figures) includes a switch that closes the electrical circuit of the electrosurgical systems described herein when the return electrode is placed on or around the return electrode  132 ,  180 . 
     For example, in at least one embodiment, the return conductors of the present disclosure may include a reed switch disposed within the return conductor or return cable  114  and a magnet disposed within the return electrode  132 ,  180 . In such an embodiment, the magnetic field produced by the magnet in the return electrode  132 ,  180  causes metal contacts within the reed switch to contact one another, thus activating the electrosurgical system  101  (as seen in  FIG. 2 ). 
     In at least one example, the return conductors and/or return cables  114  of the present disclosure include one or more mechanical switches, such as a push switch or other mechanical switch, to activate the electrosurgical system  101  when the return conductors of the present disclosure are secured to the return electrode  132 ,  180  during use. Other switches commonly known and used in the art are also contemplated and may be used to perform substantially the same function as the reed switch and mechanical switch described above. 
     In addition, the various embodiments and elements of electrosurgical systems described herein are not necessarily exclusive of one another. Rather, some or all of the features described in each embodiment and/or element of electrosurgical systems described herein may be combined together with features and/or elements of other embodiments. 
     The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.