Electrosurgery is one of the technologies used during most surgical procedures. There are many terms related to electrosurgery with which you may want to be familiar prior to your surgical procedure.
In particular, there are many vocabulary words that you may or may not be familiar with that you may hear the doctor use. If you are familiar with these words then you will be able to understand what he or she says and what is going on better.
The first term you may not be familiar with is desiccation. Desiccation refers to when the radiofrequency electricity applied through an electrical pen is applied through direct contact with the skin or tissue in a very concentrated or small area.
The electricity applied in this case caused the cells with which the pen contacts to lose their water. As a result, the below blood vessels are thrombosed.
Thrombosed is another term that you may or may not be familiar with. Thrombosed is basically the clotting of blood described in the simplest terms.
The desiccation of tissue can happen when the surgeon properly uses the coagulation or cutting settings on the generator that supplies energy to the pen.
Fulguration is most likely another term that you are not familiar with. Fulguration is another method in which the electrical pen is used.
In this method, the pen is held above the tissue and the energy is allowed to spark above it. This sparking chars the surface.
In the fulguration, or spray coagulation mode, a current is pushed through the circuit with a higher peak to peak voltage. As a result, the energy that hits the tissue, hits the surface level with high voltage.
The charring of the surface of the tissue also creates a coagulation effect. Coagulation is another term that most people are unfamiliar with when they go in for surgery.
Coagulation is the thickening of liquids, such as blood, to form a coagulum which stops bleeding.
Fulguration uses the coagulation setting on the generator. The generator must produce a high voltage in order to produce the sparking effect however. Most fulguration modes of generators product voltages between 7,000 and 10,000 volts peak to peak.
The last effect the electrical pen that most surgeons use can have on the tissue is called cutting. While you are most likely familiar with the term 'cut' you are probably not aware of how electrosurgery achieves the cutting.
When the cut setting is applied to the pen, the current applied to the skin actually vaporizes the fluid found within a cell. The contact point of the pen is very small, so only a few cells have their liquid vaporized.
However, the vaporization of their liquid causes these cells to explode. As the cells explode, a division in the tissue can be seen.
The division of the tissue looks very similar to a normal cut. It is interesting to note that the pen should never actually touch the tissue as the energy jumps off the end to the cell to vaporize the liquid.
In addition to these three different settings supplied to the pen by the generator, there are two different types of electrosurgical generators. These two types are referred to as ground referenced generators and isolated generators.
The ground referenced generators are mostly considered to be something of the past and outdated. The main difference in these models is that the generator is linked to the ground in ground referenced units and a floating ground is used in isolated systems..
A generator referenced to ground is not necessarily a good thing as the current may not travel to the intended area, but various other sites rather than the patient return electrode placed under the patient. If this occurs, the patient may receive burns in other areas that are not being operated on.
These burns generally are located where the body has small contact with other conductive objects that are grounded. As the newer generators do not have these problems, they are considered to be modern technology and are currently more commonly found in the operating room.
Isolated generators essentially require all of the electrosurgical current that is put out by the generator to be returned back to the generator by the patient return electrode to complete the electrosurgical circuit.
However, if the pad is improperly placed under the patient, a burn can still occur. The decision as to which generator is used and how the electrical pen is used are judgment calls made by the surgeon and are dependent on the type of operation that is needed.
Author Resource:-
Jack R. Landry has worked in surgical equipment sales for the past 15 years. He has great advice and information on an Electrosurgery Unit.
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