One of the tools used by surgeons is an electrosurgical blade. These large surface blades are active electrodes on them for incision which are used for cutting and coagulating tissue.
The tool is similar in appearance to a scalpel, but is attached to a radio frequency generator. Electrosurgical blades can cauterize small blood vessels as the edge cuts through tissue, making them a beneficial asset to surgeons by minimizing blood loss.
When the electrosurgical blade was first introduced to the medical field, it was a stainless steel electrode that had placed radio frequency current into the patient. The current would flow from the surgical site, through the patient, and then to the "patient plate" or return electrode.
Current would then exit the patient via the "patient plate" and be returned back to the generator to complete the electrosurgical circuit. The current that exists the body is dispersed over a large area to minimize the risk of a patient burn.
The current at the active electrode in the surgical site is very concentrated so it can do its work of cutting and coagulating. This type of electrosurgery is termed monopolar.
Bipolar electrosurgery has the active and return electrodes on the instrument itself. Current flows from the active portion of the instrument to the return portion of the instrument to complete the electrosurgical circuit. The only tissue that has current flowing through it is the tissue between the active and return portions of the instrument.
The blades used in the medical field today concentrate the radio-frequency current to the immediate vicinity of the edge. Needle electrodes typically require less power because they focus the electrosurgical energy more than a blade electrode creating high current densities.
Some electrodes have an insulating material that covers the majority of the active tip. The added insulation protects the patient from unwanted stray current from damaging adjacent tissue.
These types of electrodes are often referred to as modified electrodes. Cautery is a term that is often confused with electrosurgery.
Most clinicians use the words interchangeably, but there is a distinct difference between cautery and electrosurgery. Both cautery and electrosurgery are used to create hemostasis.
Hemostas is stopping the bleeding. In this case that occurs in surgery.
Cautery is the application of a hot instrument to blood vessels to stop bleeding. Electrosurgery uses the electrical current flow to pass through the tissue, encounter resistance to its flow, create heat, form a coagulum, and stop the flow of blood.
In the past, cauterization of open wounds or other surgical operations like amputation of a limb was performed with hot irons. This procedure helped in closing off the bleeding vessels so as to protect from infection.
Cauteries are instruments that use heat or caustic substances to destroy tissue or coagulate blood. Unlike the electrosurgical blades, cauteries may use battery power to generate a current that does not enter the patient's body, but rather uses the current to heat the instrument.
It is used in surgery to destroy tissue by burning. Cauteries are popular for many medical procedures for pinpointing areas in need of heomeostasis, or controlling bleeding.
It is good for coagulating minor bleeding and is commonly used in minor surgical procedures. General uses of cauteries in the medical field are plastic surgery, dermatology, and other fields.
Monopolar electrosurgery is the most common technology for achieving hemostasis during major surgical procedures that are typically performed in hospitals and surgery centers. Patient Return Electrodes are also called grounding pads.
They collect the monopolar therapeutic current that has entered the patient, and allows it to be safely removed and returned to the generator. The active electrode is an electrosurgical electrode that concentrates the electric therapeutic current at the surgical site and they deliver a concentrated current to the targeted tissue in the body.
Author Resource:-
Tommy Greene has worked in surgical equipment sales for the past 15 years. He has great advice and information on an Electrosurgery system.
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