The electrosurgical or electrosurgical unit, also called an electrosurgical unit, is a medical device that uses electrical phenomena to produce heat; its objective is to coagulate, glow, desiccate or cut tissues, depending on the established parameters. The production of heat is achieved through the passage of an oscillatory electric current, concentrated in a small area. The smaller the space in which the current flows, the higher the energy density at this point, resulting in higher and higher temperatures.
The heat energy comes from the electrons moving from the atoms at the rate of a difference in electrical potential (that is, their movement from the area with the highest electrons to the lowest electrons); This movement of particles produces photons that carry energy, which is transformed into heat energy.
How do electrosurgical units work?
Electrosurgical units, also known as electrosurgery or hot knife, use high-frequency electrical energy to generate heat to coagulate or cut biological tissues. Frequencies above 200,000 Hz are used since these do not interfere with nervous processes.
The impedance, or resistance to the passage of electrons, that the tissues present, manifests itself with an increase in heat, which is what causes the desired effect. Thus, with an unmodulated electrical wave, a pure cut occurs, but if the wave is modulated or interrupted, coagulation is achieved. The patient is part of the electrical circuit that makes up the electrosurgery equipment, therefore improper use can cause burns.
Parts and circuit of these devices
An electrosurgical unit consists essentially of the following parts:
- Indicators of the operating modes.
- Power selectors.
- Electrodes
- Foot switch
Benefits of electrosurgery
Electrosurgery has been shown to be able to rapidly cut and cauterize tissues with minimal thermal damage and favorable cosmetic results. In addition, we can mention the following benefits of current electrosurgery units:
- They substantially reduce tissue bleeding, thus avoiding the use of gauze, which are related to surgical site infections.
- It ensures good asepsis and reduces the probability of transmitting infections from diseased to healthy tissues.
- Considerable time savings.
- Variety of instrumentation, suitable for each surgical act.
Evolution of electrosurgery
Electrosurgery was born from the collaboration between the neurosurgeon Harvey Cushing and the inventor William T. Bovie in the 1920s. Although he was unaware of the physics behind this groundbreaking invention, Dr. Cushing was able to perform surgeries that were previously inoperable, thanks to the decreased bleeding that electrosurgery provided.
Today, more than 80% of surgeries use devices that apply energy to tissues. In fact, most surgical specialties have benefited from electrosurgical units. Although monopolar and bipolar energy form the basis of electrosurgery, over the years modifications have been made to both electrosurgical generators and instruments handled by the surgeon. All in search of reducing complications and increasing the surgical efficiency of electrosurgery.
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