ELECTROSURGERY

Electrosurgery is a widely used surgical

technology that employs high-frequency
electric current passing through tissue to cut
or cauterize that tissue.
Electrosurgery is based on the transformation
of an energy current into heat, with the
resulting effect of cutting and coagulating
tissue at the point of current application.
HISTORY
 THERMAL CAUTERY - a medical practice or technique of burning a
part of a body to remove or close off a part of it. It destroys some
tissue in an attempt to minimize bleeding and damage, remove an
undesired growth, or minimize other potential medical harm.
 Use of Conductive heating (6th century BC)
 1st ERA: Static Electricity
 2nd ERA: 1786 (Galvanization-refers to any of several electrochemical
processes named after the Italian scientist Luigi Galvani.)
 3rd ERA: 1831 (Faraday and Henry showed that a moving magnet could
induce an electrical current in wire)
 1881- Morton: current at 100kHz could pass the human body
 1891- Alex d’Arsonval: current at 10kHz directly influenced body
temperature, oxygen absorption, carbon dioxide elimination.
 1897- Franz Nagelschmidt: diathermy (heating effect which
was discovered by d’Arsonval)
 1900- Joseph Rivere: used arcing current to treat
carcinomatous ulcer first true use of electricity in surgery.
 Early 1900’s- Simon Pozzi’s fulguration. Doyen’s
electrocoagulation
 1910-1914- Willian Clarke: dessication
 1926 – William T. Bovie and Harvey Cushing: constructed an
electrosurgical unit that produced high-frequency current
delivered by a “cutting loop” to be used for cutting,
coagulation(also known as clotting), and desiccation(state of
extreme dryness, or the process of extreme drying)
ELECTROSURGICAL UNIT (ESU)
MODES OF ELECTROSURGICAL UNIT
 1. MONOPOLAR ELECTROSURGERY - Monopolar techniques are used for
cutting, fulguration and dessication. Cutting and fulguration require
sparking and high voltages whereas desiccation needs a large current
flow through the patient
 2. BIPOLAR ELECTROSURGERY - Bipolar techniques are used for
dessication without sparking which avoids damage to adjacent tissue
caused by the arc and spraying of high frequency current and are used
in delicate highly conductive tissue.
BLOCK DIAGRAM OF ESU:
TYPES OF WAVEFORMS GENERATED THE THE
ESU
 1. CUTTING CURRENT - The high average power creates a higher current
density than is allowed by other waveforms, facilitating a smooth cutting
action without extensive thermal damage.
 2. COAGULATION CURRENT - These peak voltages result in high tissue
temperatures, and hence significant thermal destruction, making this
type of current particularly suited for the coagulation of bleeding
vessels.
 BLENDED CURRENTS - Blended currents allow the surgeon to cleanly
divide tissue while maintaining a variable degree of hemostasis,
depending on the amount of coagulating current used. The new
waveform is then delivered in intermittent bursts at a rate
determined by the settings of the electrosurgical generator