Gone are the days when every surgical procedure required you to administer anaesthesia before surgery. Technological developments in the medical field have realised electrosurgical procedures, which you may or not perform with your patient under anaesthesia. These electrosurgical systems are composed of diathermy forceps, a handpiece of electrodes, and a diathermy generator that includes the power supply and the waveform generator.
With electrosurgery, after prepping the patient, you apply the electrodes to the affected areas. The contact points of these electrodes then deliver electrical current to the affected areas to heat or char the surrounding tissue with the aim of desiccating, vaporising or removing damaged tissues.
The Two Types of Electrosurgical Procedures
Electrosurgical devices are created to achieve surgical cutting while still controlling bleeding during surgery and you can perform surgical procedures in either of the two modes: monopolar or bipolar electrosurgery.
1. Bipolar Electrosurgery
In bipolar electrosurgery, the active and return electrode functions are actively engaged at the actual points of surgery, where both tips of the diathermy forceps perform the two electrode functions. The only element that completes the electrical circuit between the electrodes is the target tissue. Thus, you don’t need a complete return electrode in bipolar electrosurgery as the other tip of the pair of forceps performs this function.
2. Monopolar Electrosurgery
On the other hand, monopolar electrosurgery has only the active electrode at the actual points of surgery. The return electrode, which is a dispersive pad, is placed on the patient’s body to ground the current. The patient’s body completes the electrical circuit between the active electrode and the dispersive pad.
Applications of Electrosurgery
Continual advancements in the development of electrosurgical devices have since attracted numerous applications in improving certain dental procedures. Electrosurgery is also becoming indispensable in performing cardiac, orthopaedic, spine, plastic, ENT, ocular, general, urological, gynaecological, neurological, maxillofacial, dermatological surgical procedures.
Bipolar electrosurgery, in particular, attracts numerous applications in surgical procedures that require you to control bleeding in a wet field since this mode of surgery permits haemostasis in and around fluid environments.
While there have reports of accidental surgical fires from using these diathermy generators, modern electrosurgical machines come with built-in safety features to reduce the occurrence of such incidences due to poor electrical contact. It is, therefore, important that you confirm with your equipment supplier that you get the best and safest option for your next surgical procedures.