SEARCH · PubMed Health

Results for “ELECTROSURGERY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources

PubMed1998

Active electrode monitoring. How to prevent unintentional thermal injury associated with monopolar electrosurgery at laparoscopy.

BACKGROUND: In recent years, the use of minimally invasive surgery (MIS) has expanded to a wide variety of surgical specialties. The increased popularity of the procedure, however, has been accompanied by its share of complications, including trocar lacerations and inadvertent thermal injuries to nontargeted tissues during monopolar electrosurgery. METHODS: A survey on electrosurgical thermal injuries and three case studies are presented. The new technology of active electrode monitoring (AEM) is described. RESULTS: AEM eliminates stray currents generated by insulation failure and capacitive coupling. CONCLUSIONS: To reduce the incidence of injury by monopolar electrosurgery at laparoscopy, there is a need for advanced technology, such as AEM. In addition, laparoscopic surgeons should be encouraged to study the basic concepts of the biophysics of electrosurgery.

Adult↗

PubMed2001

Electrophysical properties of electrosurgery and capacitive induced current.

BACKGROUND: Although electrosurgery is one of the most commonly used technologies in the operating room, its electrophysical properties, including the potential for complications, are poorly understood by many surgeons. METHODS: We describe the experimental simulation of a highly unusual complication that occurred during a surgical procedure requiring concurrent use of monopolar and bipolar electrosurgery. RESULTS: Capacitive induced current from an activated monopolar electrode to the bipolar cord was reproduced and consistently led to full-thickness burns in our experiments. CONCLUSIONS: Surgeons should be familiar with the principles of electrosurgery, its electrophysical properties, and possible complications.

Burns, Electric↗

PubMed1983

Pregnancy following salpingostomy: comparison between CO2 laser and electrosurgery procedures.

The purpose of this study was to investigate the value of the CO2 laser in tubal surgery. The results of CO2 laser and electrosurgery procedures in salpingostomy were compared. From January 1977 through December 1978, 30 salpingostomies were carried out by electrosurgery. From January 1979 through January 1981, 38 salpingostomies were carried out by CO2 laser. All cases were performed using a microsurgical approach by the same two surgeons. The results for both groups were analyzed and compared. Despite a slight improvement in the term pregnancy rate with the use of the CO2 laser, no statistically significant difference was found between the two procedures in this series. The CO2 laser's ability to cut bloodlessly through tissue with minimal damage allows all procedures of tuboplasty and results in surgery easily and quickly achieved. This experience suggests that the CO2 laser now represents a safe and effective alternative to electrosurgery in tubal microsurgery.

Adult↗

PubMed2001

Laparoscopic staging of endometrial cancer using laparosonic instruments: comparison with electrosurgery.

OBJECTIVE: To compare perioperative parameters in two groups of women with different laparoscopic operative techniques in surgical staging of endometrial cancer (EC). STUDY DESIGN: Thirty randomly allocated and laparoscopically treated women with EC. Fifteen patients were operated by electrosurgery, 15 patients by laparosonic operative technique. Differences between the two groups were determined by the Wilcoxon rank-sum test. Probability (P) of less than 0.05 was considered significant. SETTING: Department of Gynecology and Obstetrics, Endoscopic Training Center, Baby Friendly Hospital, Kladno, Czech Republic. RESULTS: Laparoscopy was successfully completed in 29 patients. Laparoscopy-assisted surgical staging of EC was performed based on the tumor grade and the depth of myoinvasion. In both groups, in total 18 and 5 women underwent pelvic lymphadenectomy (PLN) and infra-aortic lymph node sampling (IALS), respectively. Three patients had metastases in pelvic lymph nodes. In the electrosurgical hemostasis and laparosonic group the mean total time required to finish the whole operative procedure were 132.1 and 138.3 min, respectively, with no statistically significant difference (P=0.96). There were no significant differences between the groups in any intraoperative or postoperative follow-up variables, except for the number of excised lymph nodes where the difference between electrosurgery and laparosonic group (12.7 versus 18) was statistically significant (P=0.05). In one patient with intraoperative venous bleeding the laparosonic hemostasis was ineffective (successful procedure rate 93.3%). One patient from the electrosurgery group was converted to laparotomy due to injury to the epigastric vessels. This complication had no connection with the surgical techniques studied. CONCLUSION: It is concluded that both operative technique variants in laparoscopy-assisted surgical staging appear to be feasible and effective for patients with EC.

Adenocarcinoma↗

PubMed2006

Understanding submucosal electrosurgery for the treatment of nasal turbinate enlargement.

The surgical management of inferior turbinate enlargement is controversial. Submucosal electrosurgical techniques for turbinate reduction include conventional diathermy, radiofrequency tissue reduction and coblation. All electrosurgical techniques use radiofrequency electricity to damage turbinate tissue but differ in the control and delivery of energy. This review will examine the history of submucosal electrosurgery and clarify the various techniques. This review will also examine the evidence for the efficacy and safety of electrosurgery for the treatment of nasal turbinate enlargement, and will make a case that no progress will be made in clinical trials on the safety and efficacy unless there is standardisation of equipment and techniques in nasal electrosurgery.

Diathermy↗

PubMed2001

Electrosurgery, pacemakers and ICDs: a survey of precautions and complications experienced by cutaneous surgeons.

BACKGROUND: Minimal information is available in the literature regarding the precautions implemented or complications experienced by cutaneous surgeons when electrosurgery is used in patients with pacemakers or implantable cardioverter-defibrillators (ICDs). The literature pertinent to dermatologists is primarily based on experiences of other surgical specialties and a generally recommended thorough perioperative evaluation. OBJECTIVE: To determine what precautions are currently taken by cutaneous surgeons in patients with pacemakers or ICDs, and what types of complications have occurred due to electrosurgery in a dermatologic setting. METHODS: In the winter of 2000, a survey was mailed to 419 U.S.-based members of the American College of Mohs Micrographic Surgery and Cutaneous Oncology (ACMMSCO). RESULTS: A total of 166 (40%) surveys were returned. Routine precautions included utilizing short bursts of less than 5 seconds (71%), use of minimal power (61%), and avoiding use around the pacemaker or ICD (57%). The types of interference reported were skipped beats (eight patients), reprogramming of a pacemaker (six patients), firing of an ICD (four patients), asystole (three patients), bradycardia (two patients), depleted battery life of a pacemaker (one patient), and an unspecified tachyarrhythmia (one patient). Overall there was a low rate of complications (0.8 cases/100 years of surgical practice), with no reported significant morbidity or mortality. Bipolar forceps were utilized by 19% of respondents and were not associated with any incidences of interference. CONCLUSIONS: Significant interference to pacemakers or ICDs rarely results from office-based electrosurgery. No clear community practice standards regarding precautions was evident from this survey. The use of bipolar forceps or true electrocautery are the better options when electrosurgey is required. These two modalities may necessitate fewer perioperative precautions than generally recommended, without compromising patient safety.

Data Collection↗

PubMed2002

Use of electrosurgery in the perioperative setting.

The concept of using heat to stop bleeding goes back hundreds of years. Researchers have constructed a variety of devices that used electricity as a means to heat tissue and control bleeding. Electrosurgery became widely used in the late 1920s because of the urgent need to safely control bleeding in operative procedures. This article will cover basics of electricity and electrosurgery, clinical applications, technologies, and nursing care during electrosurgery.

Blood Loss, Surgical↗

PubMed1992

In-vivo studies of uterine electrosurgery.

OBJECTIVE: To study the effects of electrosurgery on the living human uterus. DESIGN: Prospective observational study. SUBJECTS: Nine women with recurrent refractory dysfunctional uterine bleeding, listed for hysterectomy. INTERVENTION: Experimental endometrial resection on patients immediately prior to hysterectomy. MAIN OUTCOME MEASURES: The influence of power output, duration of exposure and repetition of consecutive surgical applications on the size of the zone of thermal necrosis in uterine tissue. RESULTS: Resection of the endometrium was associated with a narrow zone of thermal necrosis of between 0.69 and 0.76 mm which was not dependent on power output. Duration of exposure, however, was directly related to tissue necrosis (1.44 vs 1.88 mm for 1s and 5s, respectively). Coagulation by pin-point desiccation caused a zone of thermal necrosis of 3.30-3.77 mm that was independent of either power or duration of exposure to electrical energy. Thermal transmission through the uterus in situ, during electrosurgery was minimal, the maximum recorded rise in temperature from the baseline was 0.4 degrees C. The differences between the in vitro and in vivo effects of electrosurgery are highlighted and the possible reasons for these differences explored. CONCLUSIONS: The potential for unwanted thermally-induced damage to the uterus is small.

Electrosurgery↗

PubMed2004

Ignorance of electrosurgery among obstetricians and gynaecologists.

OBJECTIVE: The purpose of this study was to assess the level of skill of laparoscopic surgeons in electrosurgery. DESIGN: Subjects were asked to complete a practical diathermy station and a written test of electrosurgical knowledge. SETTING: Tests were held in teaching and non-teaching hospitals. SAMPLE: Twenty specialists in obstetrics and gynaecology were randomly selected and tested on the Monash University gynaecological laparoscopic pelvi-trainer. Twelve candidates were consultants with 9-28 years of practice in operative laparoscopy, and 8 were registrars with up to six years of practice in operative laparoscopy. Seven consultants and one registrar were from rural Australia, and three consultants were from New Zealand. METHODS: Candidates were marked with checklist criteria resulting in a pass/fail score, as well as a weighted scoring system. We retested 11 candidates one year later with the same stations. MAIN OUTCOME MEASURES: No improvement in electrosurgery skill in one year of obstetric and gynaecological practice. RESULTS: No candidate successfully completed the written electrosurgery station in the initial test. A slight improvement in the pass rate to 18% was observed in the second test. The pass rate of the diathermy station dropped from 50% to 36% in the second test. CONCLUSION: The study found ignorance of electrosurgery/diathermy among gynaecological surgeons. One year later, skills were no better.

Clinical Competence↗

PubMed1976

Excisional electrosurgery (endothermy) in dermatology.

The physical characteristics of electrosurgery are reviewed and the peculiar behavior of the cutting current is described. The indications for excisional by electrosurgery are discussed and the procedure is described. The advantages and disadvantages of the method are given. It is concluded that the overall results of excisional electrosurgery compare very favorably with other surgical procedures on the skin.

Basal Cell Carcinoma↗

PubMed1976

A comparitive study of the healing of wounds made by scalpel and electrosurgery in rabbits.

A study in the rabbit of the healing of wounds made by electrosurgery and scalpel showed less damage to the tissues arose with the scalpel and healing was more advanced at 24 and 48 hours. More extensive bleeding occurred when electrosurgery was used on the tongue. At 72 hours extensive fibrous tissue was seen but infiltration with inflammatory cells was heavier where electrosurgery was used. Epithelium had covered all wounds at seven days but basal cell layers were not complete and papillae had not reappeared on the tongue.

Animals↗

PubMed1991

Electrosurgery-induced endotracheal tube ignition during tracheotomy.

Electrosurgery was the most common source of ignition for operating room fires prior to the advent of lasers. When combined with volatile anesthetic mixtures, electrosurgery has caused ignition of plastic, rubber, paper, enteric gases, and combustible preparation solutions. We report on an intubated patient whose polyvinyl chloride endotracheal tube ignited during a tracheotomy performed with an electrosurgical unit. The oxygen-rich environment, the polyvinyl chloride tube, and the heat generated by the electrosurgical unit combined to produce a fire. Since otolaryngologists are called upon often to perform tracheotomies on intubated patients, it is imperative that they understand the factors involved in the development of such a fire. This case is presented with an explanation of why this type of fire occurs. A brief review of the literature is included. Different kinds of electrosurgical units, precautions as to their use, and the management of electrosurgery-induced endotracheal tube fires are also discussed.

Child, Preschool↗

PubMed2002

Electrosurgery for the skin.

The purposes of electrosurgery are to destroy benign and malignant lesions, control bleeding, and cut or excise tissue. The major modalities in electrosurgery are electrodesiccation, fulguration, electrocoagulation, and electrosection. Electrosurgery can be used for incisional techniques that produce full-thickness excision of nevi, for shave techniques that produce partial-thickness removal of superficial lesions, and for removing vascular lesions such as hemangiomas or pyogenic granulomas. The correct output power can be determined by starting low and increasing the power until the desired outcome is attained (destruction, coagulation, or cutting). Smaller cherry angiomas can be electrocoagulated lightly. Larger cherry angiomas may be easier to treat by shaving them first, then electrocoagulating or desiccating the base. The elevated portion of pyogenic granulomas can be shaved off with a scalpel or a loop electrode using a cutting/coagulation current. The base of the lesion is curetted to remove the remaining tissue and then electrodesiccated. Complications such as burns, shocks, and transmission of infection can be prevented by careful use of the electrosurgical equipment.

Current Procedural Terminology↗

PubMed2003

[Thermal injury and wound healing of the endometrium subsequent to minimally invasive transendoscopic use of Nd:YAG-laser-and electrosurgery in horses].

Transendoscopic thermal preparation techniques like laser- or electrosurgery have proved to be most reliable for minimal invasive intrauterine surgery during operative hysteroscopy in mares. To determine the effect of Nd:YAG laser surgery on the endometrium and the complete uterine wall compared with electrosurgery, standard lesions were obtained by transendoscopic monopolar electrosurgery (loop electrode, cutting blade) and Nd:YAG laser surgery (contact, bare fibre, 25 Watt, exposure time four seconds, non contact, 80 Watt, exposure time four seconds) in five healthy mares on days d 0, 7, 14, 18 and 21. The gross effects were controlled endoscopically before the consecutive lesions were set. Following the last diathermic endometrial irritation, hysterectomy was performed under general anaesthesia. Recovery of the mares was uneventful. Specimens from the lesions were collected after dis-section of the uterus, fixed in formalin, routinely embedded and stained with H. E. for histological evaluation. The different energy forms caused tissue alterations of comparable quality but differing in degree. Most intensive peripheral hyperemia and tissue edema occurred on postoperative days three to seven. Non contact laser irradiation initiated maximal amount of fibrinous exudate. Lesions created with a loop electrode were superficial only and did only affect the endometrium. Preparation with an electrosurgical cutting blade or a laser bare fibre resulted in craterlike lesions lined by carbonisation and did involve deeper layers of the myometrium. The lesions caused by non contact laser irradiation affected all layers of the uterine wall. Three weeks postoperatively, reepithelization of the luminal epithelium was completed. The depth of thermal injury and coagulative necrosis, inflammatory reactions and scar formation was greater in lesions created by laser application compared with those set with a loop electrode at power densities comparable to those usually achieved at hysteroscopic surgery. The results suggest that an electrosurgical loop designed for operative hysteroscopy may be a reliable tool for diathermic resection of pathological endometrial structures like uterine cysts characterized by minimal thermal injuries and a short period of reconvalescence. Non contact laser irradiation may result in deep thermal injuries with the risk of delayed uterine perforation but may be profitable for treatment of partly intramural structures like an intramural leiomyoma.

Animals↗

PubMed1991

Laparoscopic cholecystectomy: laser versus electrosurgery.

Laparoscopic cholecystectomy has been reported to be a safe and effective way to remove a diseased gallbladder with essentially no morbidity or mortality (1,2). This procedure was first introduced in Europe using electrosurgery, and later introduced in the United States using the laser (1). No clinical trial compares the laser to the standard electrosurgery method. In a review, as well as an ongoing study, morbidity, mortality, intraoperative procedures, indications, and cost effectiveness are considered in these two groups. Three hundred cases were reviewed with 150 patients in each group. There were no deaths or significant complications in either group. In the laser group, bleeding seemed slightly more excessive during removal of the gallbladder from the liver bed and required more time to control. The electrosurgery group required slightly less operative time and was less costly. The postoperative recovery time was the same in each group.

Activities of Daily Living↗

PubMedDate not supplied

Fundamentals of electrosurgery.

Electrosurgery uses electricity to remove tissue, coagulate bleeding, or destroy tumors. Modern units, first developed for application in neurosurgery, are now available in office models that are most commonly used by the family physician for cutaneous surgery. Electrosurgery can accomplish cutting, coagulation, desiccation, and fulguration. Electrosurgical equipment for the office is relatively inexpensive and portable. The main advantage of this surgical modality is rapid completion of the procedure with minimal surgical time, because hemostasis occurs at the time of the incision. After some basic instruction and initial practice on animal tissue, which are provided through the guidance of several excellent texts or continuing education courses, the family physician can readily apply electrosurgery in an office-based practice safely, efficiently, and with satisfying results.

Clinical Protocols↗

PubMedDate not supplied

Direct-current potentials created by arcing during monopolar radiofrequency electrosurgery.

Muscle and nerve stimulation during radiofrequency electrosurgery has been a well-known phenomenon for over 50 years. However, as electrosurgery expands into new procedures, such as tissue ablation in the heart, the mechanism of the potentially deleterious stimulation becomes more important. This article presents data showing that large DC currents are generated during electrosurgery and that these potentials increase with increasing sparking at the active electrode. The data also show DC potentials generated by various generators, different operation modes (cut, coagulation, fulguration), and operations on tissues of various impedances.

Electric Conductivity↗

PubMedDate not supplied

How to avoid surface burns during electrosurgery.

Electrosurgical burns are said to be the most common electrical hazards in operating rooms. Characteristic of all burns is that the user is not sufficiently familiar with electrosurgery, its power, and possible dangers. The simplest way to avoid burns is to educate those engaged in electrosurgery. There always will remain a risk that should lead to technical solution of the problem. From the physics of electrosurgery and heat production, it can be shown that a residual voltage across the neutral electrode plays a dominant role. To monitor this voltage and process it in an appropriate way will open new possibilities in avoiding burns.

Burns, Electric↗