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 541 records · Page 30Linked to original sources

PubMed1982

Guidelines for the purchase, placement, and use of electrosurgical equipment.

Many excellent clinicians present a myriad of electrosurgical techniques in this tissue. If you select techniques that are applicable to your type of practice, you will be a better, happier, and more productive dentist. The type of unit you select must also fit into your approach to patient treatment. As can be deduced from the equipment guide, there is no uniformity in the manufacture of electrosurgical equipment. There is no standardized color coding system, no uniform labeling of controls and outlets, and no uniformity in the types of current offered. Each manufacturer can produce evidence for the superiority of its unit; the scope of this article is not to evaluate units. The American Academy of Dental Electrosurgery has been active in promoting the use of uniform nomenclature by manufacturers. For more detailed information, the reader can contact the secretary and founder of this organization, Dr. Maurice Oringer, at American Academy of Dental Electrosurgery, 57 West 57th Street, New York, New York 10019. It is crucial for the dentist to known the uses and the refined methods of electrosurgery that he intends to incorporate into his practice. Only with such knowledge can he make the intelligent choice of unit and placement. There are at least 10 models currently available. It is hoped that the dentist will choose and effective unit to be used in the appropriate manner for the selected procedure. Electrosurgery will then be a splendid addition to the armamentarium of each dentist.

Dental Offices↗

PubMed1994

Endoscopy in the management of endometriosis.

Endoscopy has replaced laparotomy in nearly all patients requiring surgical treatment of endometriosis. Controlled trials have shown electrosurgery is more effective than expectant treatment in the resolution of infertility due to peritoneal endometriosis and equally effective as laparotomy. Laparoscopy surgery reduces patient morbidity and costs when compared with laparotomy. No significant difference has been demonstrated between laser or electrosurgery in resolving infertility related to peritoneal endometriosis. Peritoneal endometriosis is difficult to diagnose and its extent is obscured by occult endometriosis in microscopic foci. Biopsy is required to establish the diagnosis as all of the described lesions of endometriosis may also be due to other diseases. Excision of the lesions may be by electrosurgery, laser or scissor diathermy. Scissor diathermy has advantages over laser or electrosurgery. Endometriomas may be removed by one- or two-stage excisional surgery. Follow-up laparoscopy is often indicated because of the association with secondary adhesive formation. Pouch of Douglas endometriosis requires special attention to the identification of the extent of disease and the technique of removal. Rectal involvement may require rectal surgery, most of which can be achieved by laparoscopy. Hysterectomy and oophorectomy may be performed laparoscopically and are indicated for recurrent extensive disease not controlled by medical or conservative surgical procedures, for adenomyosis or for extensive pelvic adhesions.

Endometriosis↗

PubMed1997

Port site electrosurgical (diathermy) burns during surgical laparoscopy.

BACKGROUND: Direct and capacitive coupling of diathermy current have been reported as causes of occult injury during surgical laparoscopy. METHODS: In order to determine the incidence of electrosurgical injury adjacent to metal and plastic cannulas, skin biopsies at 19 port sites used for monopolar electrosurgery were analyzed for coagulative necrosis. Prior to surgery the cannulas were randomized to either metal or plastic. RESULTS: Coagulative necrosis was observed at nine electrosurgery port sites compared to only one control (chi2 = 4.872; df = 1; 0.05 > p > 0.02). Plastic cannulas afforded no greater protection from skin burns than metal cannulas. CONCLUSIONS: Burns may be the result of direct or capacitive coupling to metal cannulas or capacitive coupling to the skin edge across plastic cannulas. The potential exists for burns to other tissues also in close proximity to a cannula used for electrosurgery.

Biopsy↗

PubMed1998

Does the ultrasonically activated scalpel release viable airborne cancer cells?

BACKGROUND: Viable cancer cells may implant at distant sites and cause tumor recurrence. One possible mechanism is the inadvertent exfoliation of viable tumor cells during dissection. The ultrasonically activated scalpel (UAS) uses ultrasonic energy to disrupt tissues by cavitation and produces a dense cloud of cellular debris that may contain viable cells. This study aimed to investigate the viability of airborne cells released during cancer dissection using the UAS and electrosurgery. METHODS: Flank tumors (n = 8) measuring 1 cm3 were induced in male WAG rats by subcutaneous injection of 2 x 10(6) CC531s colon cancer cells. Dissection was performed in cutting mode using the maximum power output of the respective devices. Electrosurgery was performed using a standard monopolar electrosurgical unit and a needle probe, and ultrasonic dissection was performed with the Harmonic Scalpel utilising the open surgical handset and the hooked spatula tip. The smoke plume was aspirated by a vacuum pump and bubbled under Hank's balanced salt solution to trap particulate matter. The viability of the cellular material was blindly assessed with the trypan blue test and by in vitro culture. The morphology of the cellular debris was studied by examination of cytospin preparations. RESULTS: Large quantities of cellular debris was trapped in the plume from both devices. However, no viable cells were isolated, nor did in vitro cell growth occur with either device. Examination of the debris from the UAS demonstrated a characteristic mixture of amorphous forms and very few morphologically intact cells. The cauterized tumor produced charred cells and tissue fragments. CONCLUSIONS: In conclusion, this study demonstrates that viable airborne cancer cells are not released after tumor ablation with the UAS or electrosurgery.

Animals↗

PubMed1987

Histologic evaluation of gingival response to an electrosurgical blade.

Lateral heat production during the use of electrosurgical procedures in the oral cavity causes denaturation of the connective tissue adjacent to the incision line. This study evaluated the denatured zone following electrosurgery incision in dog gingiva with a traditional tungston wire electrode and a no. 15 surgical blade adapted for electrosurgery use. The effects of using a passive electrode during surgical procedures and using an "autosensor" circuit to control power adjustment were also evaluated. It was found that a surgical blade adapted for electrosurgery produces a zone of denatured tissue that is not statistically different from that produced with a wire electrode. Moreover, no differences were noted between incisions produced with manual power adjustment and those with power controlled by the "autosensor" circuit. A significantly wider zone of denatured tissue was produced when incisions were made without a passive electrode in place.

Animals↗

PubMed2000

Electrosurgical suspension apparatus.

BACKGROUND: Dermatologic surgeons commonly employ electrosurgery. OBJECTIVE: We describe a novel, yet simple, electrosurgical suspension apparatus and variations that facilitate the performance of excision and repair, Mohs micrographic surgery, cosmetic surgery, and other forms of dermatologic surgery. METHODS: The described techniques result from more than a decade of use and refinements in electrosurgical suspension apparatuses. RESULTS: The use of an electrosurgical suspension device has eliminated electrosurgical needle stick injuries, facilitated surgery, and reduced the risk of surgical field contamination via the electrosurgical handpiece or wiring. CONCLUSION: The use of a suspended electrosurgical handpiece results in reduced surgical time, eliminates many of the inconveniences associated with the current use of electrosurgery, and facilitates the use of electrosurgery as a tool of the dermatologic surgeon.

Electrosurgery↗

PubMed2002

Impact of dental devices on cochlear implants.

A cochlear implant (CI) converts mechanical sound energy into electrical signals that can be delivered to the cochlear nerve of profoundly deaf patients. The purpose of this study was to investigate whether electromagnetic interference with the CI occurs during the operation of the electric pulp tester, apex locator, electrocautery unit, electrosurgery unit, or panoramic radiograph machine. A mastoidectomy and cochleostomy were performed on a cadaver, and a CI was implanted. The dental devices were used intraorally, and the implant's circuitry was tested after each trial. A second CI was implanted in a human skull, which was then exposed to 50 panoramic radiographs, testing the implant's circuitry after each exposure. The probability of damage to the CI by any of the devices was negligible, except for the electrosurgery unit operated at level 7, which destroyed the CI's circuitry. Therefore, although the other devices seem safe, it is recommended that the electrosurgery unit not be used on a CI patient.

Cadaver↗

PubMed1992

Electricity inside the uterus.

Although electrosurgery has been employed for decades, few surgeons have received formal training in its proper use. The erroneous belief that electrosurgery techniques increase scar formation or impair healing processes led surgeons to use other methods to deliver energy to the living cell. At the cellular level, 1 watt is 1 watt. Knowing how to calculate and administer this amount of energy is the challenge. Laser technology fostered the development of improved electrogenerators and accessories that are easier to understand and control. The use of digital reader boards, displayed in watts rather than an arbitrary dial setting, is one example. A good electrosurgical system, with proper accessory electrodes, costs only 10% of the price of the average laser. For hysteroscopic resectoscopy procedures, a thorough knowledge and appreciation of the physics of electrosurgery is a basic requirement. In the future, I hope the power density and wattage delivered at the electrode tip will be displayed easily for surgeons using the resectoscope. One day, we may have a "laser-electrode" system to meet all our needs.

Electricity↗

PubMed1991

[Malfunctioning of infusion pumps due to interference from an electrosurgical unit].

We observed the incidence of pump errors by the interference from the electrosurgical unit (Vallylab, Force 4B) set at coagulation or cut mode, with three infusion pumps: Terumo STC-523, STC-525 and STC-525-01. The STC-525-01 painted with electrically conductive paint inside was used during electrosurgery on experimental basis. Malfunctioning of the STC-523 pump occurred frequently by using electrosurgical unit set at coagulation mode and placed close to the pump. The STC-525-01 showed markedly lower incidence of malfunctioning. Therefore, the STC-252-01 pump can be used safely during electrosurgery. Additionally, we discovered, through an estimation of radiated electrical field around the electrosurgical unit, the cable of an active electrode was important as an interference source. To minimize electrosurgical interferences, we propose the following recommendations; 1) keeping the infusion pump and its AC line as far as possible from the active electrode cable, 2) keeping the output of electrosurgical unit as low as possible, 3) operating the pump with its internal battery power supply, and 4) monitoring the operation of the pump while using electrosurgery.

Electricity↗

PubMed1995

Laparoscopic cholecystectomy in 200 consecutive patients using an ultrasonically activated scalpel.

Ultrasonic energy has not been previously used for surgical cutting and coagulating. Work in our laboratory has led to the development of an ultrasonically activated scalpel that safely and effectively cuts and coagulates tissue in animals. The purpose of this study was to determine if ultrasonic energy can replace monopolar electrosurgery in human laparoscopic surgery. Two hundred consecutive patients underwent laparoscopic cholecystectomy with the ultrasonically activated scalpel. The scalpel was the sole energy form in 98 of the first 100 patients, and in all of the last 100 patients. There were no common duct injuries, reoperations, or mortality. No patient had more than a 3-g drop in hemoglobin or transfusion. The ultrasonically activated scalpel is a safe and effective energy form for cutting and coagulating tissue during laparoscopic cholecystectomy in humans. The absence of need of monopolar electrosurgery combined with hemostatic effectiveness supports the concept that the ultrasonically activated scalpel can replace electrosurgery for laparoscopic cholecystectomy.

Case-Control Studies↗

PubMed1994

Gynecologic and dermatologic electrosurgical units: a comparative review.

Electrosurgery is a popular surgical technique in which high-frequency, low-voltage electrical energy produced by an electrosurgical unit is used to excise abnormal tissue with hemostasis. In this study, electrosurgical units were critically evaluated for safety, electrical specifications, design, and performance characteristics. Quantitative electrical specification and histologic thermal artifact measurements and qualitative observations were recorded for 13 electrosurgical units representing 11 manufacturers. The Aspen Sabre 180 and Laerscope e10 were considered exemplary units based on safety criteria alone. Cut-mode thermal artifact was less than 10 microns for the Cooper Leep 6000, Laserscope e10, and Utah Finesse. A maximum fulguration distance of greater than 0.5 mm was demonstrated by the Gyne-Tech Autolepe 2000 and 4000, Laserscope e10, and the Elmed ESU 30. For gynecologic electrosurgery, the Aspen Sabre 180 and Laserscope e10 were rated best, followed closely by the Utah Finesse and Finesse II and the Gyne-Tech Autolepe 4000. Dermatologic electrosurgery may be well accomplished with many of the electrosurgical units, except as noted.

Ambulatory Surgical Procedures↗

PubMed1994

[High-frequency dental surgery near metal reconstructions].

Dental electrosurgery carries the risk of incidental contact between the active electrode and metallic restorations. So far, on-line measurements of basic physical parameters during dental electrosurgery have not been performed under realistic conditions. The aim of our experimental study in pig jaws was to describe the physical phenomena more closely. 86 teeth in the jaws of freshly slaughtered pigs received occlusal amalgam fillings. Using 3 different units electrosurgical procedures were performed adjacent to the fillings. Voltage, current, impedance and power output were registered using a computer-controlled measuring system with high temporal resolution and broad dynamic range. The impedances of the amalgam fillings ranged from 0.5 to 9 k omega, with half of them being in the lower range of 0.5 to 1.5 k omega. During contact to amalgam fillings the dental electrosurgical unit had a high power output. Contact to fillings with low impedance yielded a power output up to 50 W. The other two electrosurgical units were equipped with different power output control systems thus preventing high power output during contact to metallic restorations. In conclusion, dental electrosurgery should be improved by units with dynamic power output control.

Animals↗

PubMed2005

CAM versus nucleoplasty.

In recent years the general trend in spinal surgery has been reduction and minimalization. In general, all these have shown a moderate or good clinical result but they have been associated with serious sequelae. Plasma-mediated electrosurgery, widely used in other medical fields, has demonstrated to be well suited for this new indication. To perform the Nucleoplasty (Coblation) and the CAM (Coblation-Assisted Microdiscectomy) is use the Perc-DLE SpineWand connected to a System 2000 generator (ArthoCare Corp., Sunnyvale, CA) was used. The device functions via plasma-mediated electrosurgery (Coblation) and differs from traditional electrosurgery. From a small sample 64 operated patients with contained disc herniation were analysed and classified into those who underwent percutaneous disc decompression (PDD) using coblation technology and patients who underwent CAM. All patients who presented with PDD were considered candidates for open surgery but all of them opted for the new technique. There was no contraindication. They had discogenic low back pain and/or leg pain and the procedure was performed on an outpatient basis. Follow-up data was of 1 to 12 months. Patients' gender distribution for PDD was 65% (41.6) male, 35% (22.4) female with a mean age of 43 years. The average duration of pain before nucleoplasty was of 18 months and none of them had previous lumbar surgery. At 6 to 12 months, 80% of the patients demonstrated an improvement in pain scores (75% very good, 5% good, 15% improved but not good, and 5% no effect). None of the patients was worse. Results indicate that Nucleoplasty may be an efficacious minimally invasive technique for the treatment of symptoms associated with contained herniated disc. However, randomized controlled studies are required to know with more precision the role of this procedure. CAM procedure (13 cases) is an excellent method in cases of root compression that needs liberation or in spine stenosis.

Adult↗

PubMed1998

Reproductive outcome after treatment of mild endometriosis with laparoscopic excision and electrocoagulation.

OBJECTIVE: To compare the pregnancy rates (PRs) of infertile women with mild endometriosis treated laparoscopically by surgical excision and by electrocoagulation. Laparoscopic treatment of minimal and mild endometriosis usually is done by laser or electrocoagulation. Whether surgical excision is associated with similar results is unknown. DESIGN: Retrospective study with a historical control. SETTING: University teaching hospitals. PATIENT(S): One hundred one infertile women undergoing laparoscopic treatment of mild endometriosis. INTERVENTION(S): Forty-eight women were treated with electrosurgery (historical control) and 53 women were treated with excision. MAIN OUTCOME MEASURE(S): The PRs of the two groups of women were evaluated using life-table calculations and the Mantel-Cox test. RESULT(S): Of the total 24 pregnancies (PR: 57.1%) in the electrosurgery group, there were 3 spontaneous abortions (12.5%) and 1 ectopic pregnancy (4.2%). The total PR in the excision group was 53.5%, the abortion rate was 17.4% (4 of 23), and the ectopic PR was 8.7% (2 of 23). The median interval between surgery and conception was 10.7 months in the electrosurgery group and 13.3 months in the excision group. There was no statistically significant difference in the probability of conception between the two groups of women (Mantel-Cox test: z = 0.24). Using the Cox proportional-hazards model, the effects of age and duration of infertility were evaluated and were found not to be associated with a decreased PR. CONCLUSION(S): There is no difference in the PRs of infertile women with mild endometriosis treated laparoscopically by surgical excision and by electrocoagulation. The difference between these two modalities in women with endometriosis-related pelvic pain remains to be determined.

Adult↗

PubMed1994

Laparoscopic Radical Hysterectomy: A Preliminary Experience

From June 1993 through September 1993, we had performed four cases of laparoscopic radical hysterectomy. All these patients had early cervical squamous cell carcinoma of less than 4 cm in diameter. We first developed the left paravesical and pararectal space with the suction-irrigator probe and Endoretractor (Autosure, USA). Then we desiccated the left uterine artery at its origin. The left ureter was dissected from the point it enters the pelvis to the ureteric canal. The left cardinal ligament was completely divided twice by the EndoGIA (Autosuture, USA). The rectovaginal space was opened and the uterosacral ligament was transected by electrosurgery. The left ureter was dissected and unroofed to the point it enters the bladder with Endodissector and electrosurgery. The left paracolpos was divided by EndoGIA. The same procedures were repeated on the right side. The anterior and posterior colpotomy could be done by monopolar electrosurgery but they were deferred until the lymph node dissection was completed. Finally, we did pelvic lymph node dissection and colpotomy, after which we removed the uterus through the vagina. We closed the vaginal cuff from below. The operation time ranged from 5.5 to 8 hours. The blood loss ranged from 150 to 500 ml. The lymph nodes dissected ranged from seven to nine in number. The parametrium removed was 3.5 x 2.5 x 2 cm on average. The vaginal cuff removed was at least 2 cm in length. The patients recovered quickly and the hospital stay was shorter than that needed for those patients undergoing traditional abdominal radical hysterectomy. In conclusion, we think the preliminary results were satisfactory. More experience is needed to answer the question of whether laparoscopic radical hysterectomy can be an alternative to traditional abdominal radical hysterectomy in some selected cases.

Journal Article↗

PubMed1998

Comparison of coagulation modalities in surgery.

The increase in laparoscopic surgery has resulted in an increased need for a safe and reliable method of obtaining minimally invasive operative hemostasis. Because the traditional "open" methods of controlling bleeding (pressure, tying, and suture ligating) are not as easily applied in the laparoscopic arena, a heavy reliance on forms of tissue and vessel coagulation is necessary. To better assess these forms, we compare monopolar, bipolar, and ultrasound energy, in addition to laser energy used in a novel application. In the first part, 20 rabbit mesenteric arteries that measured 1 to 1.5 mm in diameter were coagulated using each of the technologies. We measured the time to coagulation, the efficacy of hemostasis, lateral tissue damage, and local tissue temperature of the vessels when exposed. Part 2 consisted of a survival study using 12 New Zealand white rabbits. In each of these two groups splenectomies were performed. A laser-heated forceps was compared to a monopolar electrosurgery device for the speed of the operation, blood loss, and adhesion grade at necrosectomy. In addition, the speed to cauterization of the iliac vessels and the amount of tissue damage was measured. These vessels were also examined for the extent of microscopic damage. Bipolar electrosurgery was much slower than the other modalities, while monopolar electrosurgery caused significantly more tissue damage and elevation in lateral tissue temperature. The ultrasound technology and the laser-heated forceps were equally safe and efficacious instruments. There was no significant difference in the ability of the laser-heated forceps or the monopolar cautery to perform the splenectomy safely. However, the forceps cauterized the iliac vessels faster and with less lateral thermal injury than the ultrasound device. Although each instrument has its place in the surgical armamentarium, the ultrasound technology appears to be the safest and most efficacious commercially available device for obtaining hemostasis. The laser, as it is applied in this setting, was also highly effective, but still a prototype device.

Animals↗

PubMedDate not supplied

Design hazards of electrosurgical devices.

The tremendous lifesaving value of adjunct electrosurgery to the medical profession is not without potential hazards. The hazards, which can be classified as radio-frequency burn hazards, shock hazards, electrocution hazards, and explosion hazards, may result from equipment design circuitry, possible failure modes, or operator error. The three basic electrosurgery systems currently being marketed--grounded output systems, referred-to-ground output systems, and floating output systems--are described, and the hazard potential of each system, as well as the hazard potentials of modifications of these systems, are identified. The authors propose a safety system to eliminate most of the hazards cited for the other systems, recommend minimum circuit performance requirements, and evaluate an electrosurgery standard.

Electricity↗

PubMed1997

[Relieving the obstruction caused by malignant tracheobronchial tumors under flexible endoscopy].

OBJECTIVES: We evaluate the feasibility and the efficiency of electrosurgery in the treatment of the symptomatic malignant tracheobronchial tree obstructions (MTTO) when it is used with flexible fiberoptic bronchoscopy without general anesthesia. METHODS: The aim of electrosurgery was to restore the permeability of the tracheobronchial tree to suppress symptoms. The operation lasted no more than 60 minutes, and a second operation was performed 8 days later if symptoms persisted. The patients received local anesthesia and light sedation (midazolm). PATIENTS: 28 patients have been treated from june 1995 to june 1996 for following symptoms: dyspnea (22 cases), cough (1 case), dyspnea and cough (5 cases). All patients had malignant disease palliatively treated. RESULTS: The protocol has failed in one case, needing general anesthesia. 27 patients have had one session, 6 a second one week later. After the first session, dyspnea was improved in 22/27 cases (81.5%) and cough in 5/6 cases (83%). After the second session, dyspnea was globally improved in 26/27 cases (96%), without change for cough. CONCLUSION: Electrosurgery is a feasible and safe treatment which can implement immediately without general anesthesia, in MTTO. Its result are highly effective on dyspnea but less on cough, with reproducible effects and a well-tolerated procedure. Further investigations need to compare the different techniques.

Airway Obstruction↗