Principles of Electrosurgery

Electrocautery

The current does not enter the patient body Only the heat wire comes in contact with tissue

Electrosurgery:

The circuit is composed from the generator, active electrode, patient, and patient return electrode. The patients tissue provides the impedance, producing heat as the electrons overcome the impedance

Frequency Spectrum

60~100KHz electrocution would result Nerve stimulation cease > 100KHz Electrosurgery:200KHZ ~ 3.3MHz

Bipolar Electrosurgery:

Active output & patient return are both on the site of surgery Current path is confined to tissue grasped between forceps tines Patient return electrode shouldnt be applied

Monopolar Electrosurgery:

The active electrode is in the wound The patient electrode somewhere else The current flow through the patient to the P.R.E.

Tissue select change with the waveform

~2KV ~3KV 3.5KV ~ 9KV

Electrosurgical Cutting

Electrode not in direct contact 100% ON power Maximum current Greatest amount of heat

Vaporization of tissue

Fulguration

Electrode not in direct contact 6% ON power Less current Less heat produced

Coagulum rather than vaporization

Desiccation

The electrode is in direct contact Less impedance => less heat Cells dry out rather than vaporize As a result you can coagulate with the Cut mode using far less voltage. It may be necessary to adjust power, electrode size.

Variables impacting Tissue Effect

Waveform Power setting Size of electrode Time Manipulation of Electrode Type of Tissue Clean Electrode

Tissue Response Technology

Instinct response Maintains a constant output power to produce a consistent effect

Instant Response Algorithm

Grounded Electrosurgical Systems

Isolated System

Deactivated Isolated System

Patient Return Electrode

Ideal Return Electrode Contact

Dangerous Return Electrode Contact

Return Electrode Monitoring

The system is designed to deactivate the power before an injury can occur if it detects a dangerous high level of impedance at patient / pad interface (< 5Ohm & >135Ohm)

Thanks for your attention

Good Luck