Elektrosurgical

Elektrosurgical, also spelled electrosurgical, refers to a medical technique that uses high-frequency electrical current to cut, coagulate, desiccate, or fulgurate tissue during surgery. Energy is delivered from an active electrode to tissue, with current returning via a dispersive grounding pad in monopolar systems or between two tips in bipolar systems. The tissue’s resistance converts electrical energy into heat, enabling rapid hemostasis and controlled tissue effect.

Electrosurgery is used across many specialties, including general surgery, gynecology, urology, and dermatology. Operating modes include cutting (continuous waveform for transection with minimal coagulation), coagulation (interrupted waveform for hemostasis with more tissue desiccation), and blended modes that balance effects. Monopolar units require a patient return electrode pad; bipolar units confine current between the instrument tips and do not require a return pad, providing greater precision in smaller fields.

History and development: The technique was popularized in the 1920s by William T. Bovie, with modern devices offering refined control, safety features, and a range of waveforms. Safety considerations include the risk of thermal injury to tissue or skin, unintended burns from poor pad contact or insulation failure, interference with implanted devices, and electrosurgical plume containing smoke and potentially harmful chemicals.

Among advantages are reduced blood loss, faster dissection, and improved visualization. Potential drawbacks include equipment cost, need for training, and strict adherence to safety protocols. When used appropriately, elektrosurgical techniques provide effective hemostasis and precise tissue modification in a wide range of procedures.