electrocauteryassisted

Electrocautery-assisted refers to surgical techniques that use a heated instrument to apply electrical energy to tissue for cutting, coagulation, desiccation, or fulguration, thereby facilitating dissection and hemostasis. The term encompasses methods that heat a built-in element (electrocautery) as well as devices that pass current through tissue (electrosurgery), though usage often overlaps.

Mechanism and devices: Monopolar systems deliver current from a handheld tip to a distant return pad, while bipolar systems confine current between the tips. Energy modes include cutting and coagulation, with blending options. Tissue effects depend on power, duration, and impedance, producing precise transection with varying depths of injury.

Applications: Electrocautery-assisted techniques are used across surgical specialties, including gastroenterology (hot snare polypectomy and endoscopic mucosal resection), dermatology (lesion excision and cauterization), laparoscopy and open surgery (dissection and vessel sealing), and ENT and thyroid procedures. It is also employed to control bleeding during major operations.

Safety and limitations: Benefits include rapid hemostasis, reduced need for sutures, and shorter operative times. Risks include unintended thermal injury, surgical plume, infection, collateral tissue damage, burns, and interference with implanted devices. Mitigation measures include proper grounding, careful instrument handling, adequate irrigation, smoke evacuation, and energy-setting optimization.

History: Electrosurgical techniques emerged in the early 20th century, with William T. Bovie’s pioneering devices enabling modern electrosurgery and electrocautery-assisted procedures.

See also: electrosurgery; electrocautery.