History
The first use of an
electrosurgical
generator in an
operating room
occurred on October
1, 1926. The
surgery was
performed by Dr.
Harvey Williams
Cushing
Diathermy:
 Radiosurgery
 Electrosurgery:
•
•
Monopolar
Bipolar
Diathermy
In the natural sciences, the term
diathermy means "electrically induced
heat" and is commonly used for muscle
relaxation. It is also a method of
heating tissue electromagnetically or
ultrasonically for therapeutic purposes
in medicine
Radiosurgery
Radiosurgery is a technology used to
treat a variety of soft tissue
conditions, from the skin to deeper
.tissues
Instead of using a scalpel, radio waves
.do the cutting
Radiosurgery technology is somewhat
similar to laser or electrosurgery, but
it uses a different part of the
electromagnetic spectrum than
.either
Instead of using light waves (like laser),
and instead of using hightemperature, low-frequency waves
(such as with electro-surgery),
radiosurgery uses low-temperature,
high-energy waves in the
radio bandwidth. (See the chart
below)
What's the benefit of using radio waves
instead of laser or electrosurgery?
First, the low-temperature waves used by
radiosurgery means that tissues are not
burned like they are with
.electrosurgery
And as you can see on the chart below,
the Ellman radiosurgery machine's high
energy waves penetrate much less
deeply into peripheral tissue (0.02 mm)
than CO2 laser (0.5 mm), Holmium laser
(0.05 mm), or electrosugery (1.0 mm)
.units
Electrosurgery
Electrosurgery is the application of a high-frequency
electric current to human (or other animal) tissue as
a means to remove lesions, staunch bleeding, or cut
tissue. Electrosurgery can be used to cut, coagulate,
desiccate, or fulgurate tissue
Monopolar
electrosurgical modalities There are two commonly used
The .bipolar and monopolar :or circuit topologies
is used less often, but is easier to bipolar modality
explain. Voltage is applied to the patient using a
with one tine connected to one pole ,forceps special
of the A.C. voltage source and the other tine
connected to the other pole of the voltage source.
When a piece of tissue is held by the forceps, a high
frequency electrical current flows from one to the
other forceps tine, through the intervening tissue.
The direction of this current alternates at high
frequencies, but heating takes place no matter which
direction the current flows. In this manner, the
intervening tissue is heated
bipolar
the patient lies on monopolar modality In the
a relatively large ,return electrode top of the
metal plate or a relatively large flexible
metalized plastic pad which is connected to
the other electrode of the A.C. current
,source. The surgeon uses a single, pointed
to make contact with the tissue. The probe
electrical current flows from the probe tip,
through the body and then to the return
electrode, from which it flows back to the
electrosurgical generator. It might seem that
the monopolar modality would cause heating
of the entire body cavity
monopolar
Bipolar
Other Electrosurgical modalities:
fulgeration with spark gap
For relatively low-powered monopolar
electrosurgery performed on conscious
outpatients (such as in a
or spark gap dermatologist's office), the
modalitymay be used fulguration
Prevention of unintended
burns in anesthetized patients
To prevent unintended burns, the skin should be clean
and dry and a conductive jelly should be used to
enhance contact. Proper electrical grounding
practices must be followed in the electrical wiring of
the building. It is also recommended to use a newer
electrosurgical unit that includes alarms for ground
circuit interruption
Electrosurgical waveforms
For cutting, a continuous single frequency sine wave is generated.
This produces rapid heating
For coagulation, the sine wave is turned on and off in rapid
succession. The overall effect is a slower heating process, which
causes cells to coagulate
Safety Alert:
DO NOT use or prescribe
shortwave diathermy,
microwave diathermy or
therapeutic ultrasound
diathermy (all now
referred to as diathermy)
for patients implanted
with any type of
Medtronic
neurostimulation system
These treatments are typically used for
the following purposes:
relieve pain, stiffness and muscle spasms
reduce joint contractures
reduce swelling and pain after surgery
promote wound healing
Electromagnetic heat should not be used over any areas that are
wet or filled with fluid or metal objects. The risk for burning is too
great. These include:
*eyes
*a pregnant uterus
*blisters
*moist skin or clothing
*perspiration
*wound dressings
*intrauterine device
*a pacemaker