ELECTROSURGERY UNIT

Subject code – BTY 337

BIOMEDICAL SENSORS AND MEASUREMENT DEVICES

Roll Number – 20
Registration Number – 11901597
Section – B1804

SUBMITTED BY: RIYA

SUBMITTED TO: DR. NILLOHIT MITRA RAY
WHAT IS ELECTROSURGERY?

 Electrosurgery is the use of high frequency electrical energy in the radio transmission
frequency (RF) band applied directly to tissue for cutting, destroying tissue and stopping
blood flow.
 Electrosurgery is used on nearly every soft tissue in the human body. The energy
introduced by electrosurgery reacts with water molecules within the cells of the tissue
being treated. During surgery the tissue and blood vessels are cut, which causes
bleeding. To prevent too much blood loss and to keep the operation field free of excess
blood, electrosurgical units are used.
 Different modes of operation can be set. The monopolar mode (single electrode) is used
for cutting and coagulation, the bipolar mode (forceps like electrode) is used mainly for
destroying tissue.
 Electrosurgery is not the same as electrocautery. Electrocautery uses direct current (dc)
to heat electrodes that are used to produce coagulation.

PRINCIPLES OF OPERATION
In monopolar electro surgery, tissue is cut and coagulated by completion of an electrical circuit
that includes a high frequency oscillator and amplifiers within the ESU, the patient, the
connecting cables, and the electrodes. In most applications, electric current from the ESU is
conducted through the surgical site with an active cable and electrode. The electrosurgical
current exits the patient through a dispersive electrode (usually placed on the patient at a site
remote from the surgical site) and its associated cable connected to the neutral side of the
generator. In bipolar electro surgery, two electrodes (generally, the two tips of a pair of forceps
or scissors) serve as the equivalent of the active and return electrodes in the M mode.

WHAT ELECTROSURGERY DOES?

An electric current with a frequency of about 500 kHz is used to cut and coagulate tissue. This
process involves applying an RF (radio frequency) spark between a probe and the tissue. The
electric current through the tissue heats up the tissue and evaporates the water in the cell
destroying it. This achieves special surgical effects namely cutting coagulation and desiccation.
The voltage on the electrode is between 1000-10000 V. these units should not be used on a
person with a pacemaker.

MONOPOLAR
 In monopolar electrosurgery, one electrode is active and is used to introduce current
into tissue. The other electrode is the dispersive or return electrode and is in the form
of a large flexible pad. Dispersive connection to the patient is by the means of capacitive
coupling which works through normal street clothing without direct skin contact so that
the patient reclines against the dispersive pad completing the electrical circuit.
 The active electrode is much smaller in the surface area that the dispersive electrode so
that current is highly concentrated in the area being treated. Current is distributed over
a larger area and prevent tissue damage or significant heat build-up on the patient
 Monopolar electrosurgical current flow- Current is concentrated at the active electrode
to produce cutting or coagulation; it is dispersed at the return electrode to prevent
patient burns.
BIPOLAR
 In bipolar electrosurgery, both electrodes are the same or similar size and are mounted
on a common hand piece. Current flows from the generator to the instrument, typically
forceps, through one time of the forceps, the active electrode, through the patient
tissue, to the other time, the return electrode, and returns to the generator to complete
the circuit. No separate dispersive plate or pad is used.
 This technique is used when current is restrained to the immediate volume of tissue
being treated and does not diffuse through the body. Bipolar forceps are insulated from
each other. Bipolar accessories are not safe with ground reference generations.
WAVEFORMS OF OPERATIONS:

MODE OF OPERATION: CUT

Cut uses a spark, in addition to the heat of the current passing through the tissue, to rapidly
vaporize the tissue, creating a cutting effect.

MODE OF OPERATION: COAGULATION

Coagulation or fulgeration is used for maximum haemostasis, or stopping the flow of blood. It
uses intermittent short bursts of high voltage to coagulate and char tissues cutting.

MODE OF OPERATION: BLEND

Blend is not a mixture of cutting and coagulation, but a modification of the amount on time the
generator is on, called the duty cycle. However, it has properties of both cut and coagulation.

MODE OF OPERATION: DESSICATION

Desiccation is used for destroying tissue. The cells dry out and form a coagulum rather than
vaporizing and exploding.

ELECTRODES
These are also called tips or electrode tips and come in a wide variety of sizes and shapes suited
to specific clinical indications for incision, excision, curettage and coagulation. These are held in
an insulated hand piece. Power should be turned off before switched tips to prevent electric
shock.
USES OF MEDICAL ELECTROSURGERY
 A routine part of laparoscopic and open surgeries
 Safe around pregnant patients and doctors
 Bloodless biopsy
 Surgeries with antisepsis and hemostasis
 Plastic surgeries
 Implant surgeries
 Gynecology surgeries
 Urology surgeries
 Destroy cancer cells

REPORTED PROBLEMS
There is a risk of surgical fire when using oxygen while performing electro surgery. Partial or
complete detachment of the electrode pad from the patient is a common cause of patient
burns. Burns may also result from inadequate site preparation, defective materials or
construction, or incorrect placement of the return electrode. The second most common type of
electrosurgical injury occurs when the active electrode is inadvertently energized while the tip
is in contact with non-target tissue.

PRODUCT SPECIFICATIONS
 Approx. dimensions (mm): 777 x 360 x 505
 Approx. weight (kg): 28
 Consumables: Active and return electrodes
 Price range (USD): 1,500 - 14,000
 Typical product life time (years): 7 to 10
 Shelf life (consumables): Single use or variable

COST OF PRODUCT IN INDIA

 JOHNSON AND JOHNSON – Rs. 98,000 – 4.6 LAKHS
 B BRAUN – Rs. 3.20 LAKHS
 SHALYA – Rs. 78,000
 MEDTRONIC VALLEYLAB – Rs. 5.50 LAKHS
 FORCE FX VALLEYLAB – Rs. 2.60 LAKHS

HOSPITALS WHERE ELECTROSURGERY UNIT IS USED IN INDIA

 MAX SUPER SPECIALITY HOSPITALS
 ALL INDIA INSTITUTE OF MEDICAL SCIENCES (AIIMS) HOSPITALS
 FORTIS HOSPITAL
 COLUMBIA ASIA HOSPITAL
 SAFDARJUNG HOSPITALS
 MANIPAL HOSPITAL
 BLK SUPER SPECIALITY HOSPITAL
 DR. RAM MANOHAR LOHIA HOSPITALS
 APOLLO HOSPITALS
 SIR GANGA RAM HOSPITAL
 ST. STEPHEN’S HOSPITAL
 PRIMUS SUPER SPECIALITY HOSPITAL
REFERENCE:
 Handbook of biomedical instrumentation – R.S. KHANDPUR
 Introduction to biomedical equipment technology – JOSEPH I. CARR AND JOHN
M. BROWN
 www.google.com
 www.wikipedia.com
 http:/www.who.int/medical_devices/innovation/electrosurgery_unit.pdf