The process of electrosurgery is made up of two subcategories, monopolar and bipolar. Most surgeons are experienced in both of these methods and choose when it is most appropriate to use them.
Electrosurgery is the process of using the direct application of electric currents to cut and/or desiccate tissue and stop blood flow. It has been in use for a number of years, but it is constantly being perfected and revolutionized.
Electrosurgery is utilized for all different types of procedures in the medical industry today. Some of these include dermatological, plastic, cardiac,vascular, orthopedic, and dental surgeries.
It is especially useful in situations and in areas of the body where cutting can induce a great deal of blood loss. Because it has the power to coagulate the vessels around an incision, it can minimize blood loss. Since the introduction of electrosurgery in the 1920's many surgeries have been enabled because electrosurgical tools can control bleeding while the use of a scalpel cannot control bleeding.
One type that is used is monopolar electrosurgery. With this method, a single electrode, or pencil/instrument, carries the electrical current to the surgical or incision site.
This current travels through the body of the patient to the patient return electrode, or PRE. It is then returned to the unit or generator that provided the initial electric current.
This way, it makes a complete circuit beginning in and returning to the generator. Without this, the instruments would not function properly and the process could not be completed or used safely on patients.
Monopolar type currents can be used on patients with a variety of frequencies and voltages. Most generators produce current with frequencies over 300,000 cycles per second to avoid neuro-muscular stimulation.
Generators also produce different voltages. Higher voltages are used for coagulation while lower voltages are used for cutting.
The coagulation currents also have a lower duty cycle to allow a coagulum to form over the blood vessels and achieve hemostasis. Cutting currents have a 100% duty cycle.
This means the current is flowing 100% of the time and no cooling, or hemostasis is obtained with cutting currents. Though procedures that require incisions still mostly make use of monopolar currents, a number of procedures performed use the bipolar method of electrosurgery.
Bipolar electrosurgery is most appropriate where the spread of thermal damage to adjacent tissues creates the potential for patient harm. An example of excessive thermal spread would be damaging an adjacent nerve.
Bipolar energy does not use the patient's body as a conductor to carry current to the patient return electrode and then back to the generator. Current is delivered through one tip of a bipolar instrument and is returned back to the generator through the opposing tip of the instrument.
Current only flows through the tissue between the tips of the instrument. As a result, the adjacent tissue has less of a chance of being harmed.
If it is used properly, it causes less damage to tissues. However, if the instrument is activated for longer than it should be or if too much power is used, it can be very harmful.
Thus, in bipolar surgery the usage of a patient return electrode, whether it is an adhesive patch to the patient's skin or a pad underneath them, is not needed. Any surgeon that is hoping to operate this type of machinery must have been adequately trained in proper technique.
Once you understand the different voltages and the types of cuts they make, it is simple to use. However, one must use a very gentle hand and pay close attention to current levels and electrode placement.
Electrosurgery has become very vital to the medical industry and is widely used with a great deal of different procedures. If you are having a surgery performed through either of these methods, it is best that you research them beforehand so that you understand the process and so you can ask advice of or voice concerns to your medical professional.
Author Resource:-
Tommy Greene has worked in surgical equipment sales for the past 15 years. He has great advice and information on Electrosurgery Equipment.
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