How Electrosurgery Works In Modern Medicine

Electrosurgery, despite having a name that might come from a science fiction film, is actually a very common form of surgery that is used all over the world. In electrosurgery, tools are used to heat tissue in a variety of different ways to create different results depending on the need of the surgeon. This unique form of surgery utilises alternating high-frequency radio currents to help modify human tissues. Although basic in concept, the sheer versatility of electrosurgery tools means that this form of surgery can be quite complex. To give you a better idea of what electrosurgery is all about, in this article we take a look at electrosurgery basics. 

The currents involved in electrosurgery

Although electrosurgery equipment isn’t necessarily talked about in relation to surgeries that are performed, that certainly doesn’t mean that it doesn’t have a prominent place in modern surgery. As mentioned previously, electrosurgery utilises current to modify tissue in a variety of ways. The main three forms of this include cutting, desiccation/coagulation and fulguration. Electrosurgery tools can be used to apply cutting actions through the careful use of electrical sparks. The concentrated heat that these sparks create are applied to the patient on the site where they require careful cutting. For the best result, the electrode must be held away from the skin of the patient in order for easier vaporisation of tissue due to the increased heat that form as a result of the gap. Desiccation involves the dehydration of certain sites on the patient, while the coagulant properties of electrosurgery turn liquid blood into gel. Unlike cutting, the less heat used in these processes means skin doesn’t vaporise, which is why skin dehydrates on the surface. Finally, fulguration involves the electrode instrument being placed above the desired area to coagulate and char the tissue. This occurs over a wide area, and the electrode demands higher voltage in order to overcome the high impedance of air.

Other aspects of electrosurgery to consider

In addition to these forms of affecting the tissue of the patient, a surgeon implementing electrosurgical techniques has a few other things to consider. The first of these is time, where the longer a generator is activated, the greater the heat produced. More heat means that heat travels further when applied to the desired site. It is also important to factor in the size of the electrode, as the smaller the electrode, the more concentrated the heat becomes. In practice, this translates to smaller power settings producing the same effect as higher settings if applied using a smaller electrode. The last consideration that a surgeon will have to make is regarding the kind of tissue being operated on. Because different tissues have different densities, different heat sources and electrode sizes will have to be considered depending on the task at hand. 

Electrosurgery versus electrocautery

Although electrosurgery and electrocautery are similar in name, they are actually quite different instruments used for different purposes. In practice, electrocautery uses safe for health direct current, rather than the alternate current used in electrosurgery. Although it might sound simple in theory, these currents provide very different result – direct current does not enter the patient’s body, while the current in electrosurgery enters the body of the patient in order to complete the circuit.