Is electrosurgery a revolution? Mechanism, benefits, complications and precautions

Abstract

Approximately one and a half-century ago, it was revealed that high-frequency alternating current flows through the tissue without causing a painful electrical shock and produces heat instead of muscle stimulation. The application of electrical current to the tissue produces effects such as fulguration, desiccation/coagulation, or vaporization/ablation. Devices that use high- frequency electric current are called energy devices. The development of these devices that facilitated dissection and bleeding control pioneered a new era in surgery. After the Bovie units, which have monopolar and bipolar modes, advanced energy devices were also developed. Advanced bipolar devices use pulsed bipolar energy and feedback control of the energy output during tissue coagulation. There is an electrosurgical unit in each operating theater now. However, these devices are not exempted from complications. Complications related to energy devices occur in 2 to 5 per 1000 procedures. The leading causes of these complications are the thermal diffusion effect, smoke plumes, and stray current. As the surgical experience increases, complications decrease and reach a plateau. Surgeons should understand the mechanism of action; they should have knowledge about the prevention and treatment of potential complications.

Keywords

• Electrical current
• Electrosurgery
• Energy devices
• Medical devices
• Surgical devices

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