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At least 577 records · Page 32Linked to original sources

PubMed1999

Electric and laser energy for endoscopic surgery.

Improvements in surgery have focused on refinements in the ability to dissect and limit blood loss. The electrosurgery unit (ESU) and laser (light amplification by stimulated emission of radiation) have been widely used in recent endoscopic surgery. ESU is a form of surgery in which high-frequency (100 kHz-5 MHz) electric currents are used to incise, destroy, and remove tissue and to seal blood vessels in order to maintain hemostasis. The use of lasers in surgery has added a new dimension to operative technique through increased precision, improved hemostasis, and less tissue manipulation. This paper aims to explain the basic principles and applications of electrosurgery and lasers.

Electrosurgery↗

PubMedDate not supplied

Treatment of gingival pigmentation: a case series.

A smile expresses a feeling of joy, success, sensuality, affection and courtesy, and reveals self confidence and kindness. The harmony of the smile is determined not only by the shape, the position and the color of the teeth but also by the gingival tissues. Gingival health and appearance are essential components of an attractive smile. Gingival pigmentation results from melanin granules, which are produced by melanoblasts. The degree of pigmentation depends on melanoblastic activity. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of 'black gums' are common particularly in patients having a very high smile line (gummy smile). For depigmentation of gingiva different treatment modalities have been reported like- Bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery and laser. In the present case series bur abrasion, scraping, partial thickness flap (epithelial excision) cryotherapy and electrosurgery have been tried for depigmentation, which are simple, effective and yield good results, along with good patient satisfaction. The problems encountered with some of these techniques have also been discussed.

Adult↗

PubMed1999

[Clinical observation of hysteroscopic electric resection: an analysis of 36 patients with abnormal uterine bleeding].

OBJECTIVE: To assess the efficacy and influences of hysteroscopic electrosurgery in treating abnormal uterine bleeding (AUB). METHODS: 36 women with AUB received hysteroscopic transcervical resection of the endometrium or intrauterine lesions with a continuous flow resectoscope. RESULTS: The complications rate was 8.3%. 32 patients were followed for 4 to 12 months. Menstrual symptoms ameliorated in 82.4% of the patients. 5.9% of the women became amenorrhoeic. 58.8% had only spotting, 17.6% recovered normal period. 6 out of the 8 cases with dysmenorrhea had relieved their pain. Satisfactory rate of the procedure was 76.5%. Two patients received hysterectomy later for recurrent uterine bleeding. CONCLUSION: Hysteroscopic electrosurgery is an effective procedure in treating abnormal uterine bleeding. But its long-term efficacy is yet to be identified. When improving the technique and basic knowledge, the indications should be given appropriatly.

Electrosurgery↗

PubMed2002

Dermal electrosurgical shave excision.

The dermal electrosurgical shave excision is a fast and inexpensive method of removing epidermal and dermal lesions. The procedure is ideally suited for pedunculated lesions raised above the level of the surrounding skin. It consists of repetitive, unidirectional, horizontal slicing of a cutaneous lesion with a no. 15 blade followed by electrosurgical feathering to smooth out the wound edges. A smoke evacuator is used during electrosurgery to prevent inhalation of heat-disseminated viral particles. The procedure is followed by histologic evaluation of the shaved specimen. Suspicious pigmented lesions should not be shaved because the long-term prognosis of a malignancy may depend on the thickness of the lesion on histologic analysis. Administration of adequate local anesthesia should make this a painless procedure. Basic general surgery skills are required, and formal training in electrosurgery is highly recommended.

Electrosurgery↗

PubMed2005

Cardiac devices and electromagnetic interference revisited: new radiofrequency technologies and implications for dermatologic surgery.

BACKGROUND AND OBJECTIVE: As the number of patients with implantable cardiac devices escalates, inadvertent electromagnetic interference (EMI) by electrosurgery carries increasing concern for patient safety. Given the trend for dermatologic care delivery by nonphysician providers, supervising physicians must carefully consider the adequacy of perioperative evaluation in elective or cosmetic settings. Rapidly evolving technology also calls into question potential EMI of new therapeutic modalities (radiofrequency resurfacing, electrochemotherapy, and endovenous ablation). The most recently published recommendations (1998) for care of dermatologic patients with cardiac devices do not differ significantly from guidelines proposed in 1975. These recommendations, based on complications experienced during noncutaneous surgery, are exceedingly conservative and do not take into consideration the different electrosurgical modalities and varying degrees of EMI risk. In addition, modern cardiac devices have evolved significantly with increased sophistication in protection from EMI. A survey of dermatologic surgeons demonstrated low compliance with these existing guidelines. METHODS, RESULTS, AND CONCLUSIONS: Based on a review of the literature and current electrosurgical and cardiac devices, we discuss the potential impact of conventional dermatologic electrosurgery and new technologies. We propose that new perioperative guidelines are needed to provide appropriate safety, facile implementation, and cost-effective care for patients with modern implantable cardiac devices.

Cardiac Pacing, Artificial↗

PubMed2005

Higher currents, greater risks: preventing patient burns at the return-electrode site during high-current electrosurgical procedures.

Patient burns at the site of the return electrode are a well-known, and generally well-managed, risk of electrosurgery. However, the use of newer electrosurgical devices and techniques that apply higher currents to the patient for longer periods of time has created a new set of burn risks. And the safety measures that have proven effective during conventional electrosurgery can not necessarily be relied on to prevent return-electrode-site burns during these high-current, long-activation-time electrosurgical procedures. In this article, we explain the hazards and detail the factors that can increase the risks of return-electrode-site injuries for a given procedure. We also provide recommendations to help facilities and clinicians minimize those risks.

Burns, Electric↗

PubMed1991

[Measurement of physical parameters in HF surgical techniques in dentistry].

A method for measuring electrical parameters in dental electrosurgery and new data on this surgical technique are presented. A computer-controlled system which measures voltage, current, phase, power and impedance with high temporal resolution was applied to dentistry. Statistical analysis of many operations on freshly butchered pig jaws was performed. The impedance of oral soft tissues is higher during cutting, the power required smaller than stated in the literature. The influence of frequency, power-output control, anatomical structures, and metallic restorations on dental electrosurgery is discussed in detail.

Animals↗

PubMed1991

[Recommendations for training with dental HF surgery apparatus].

A training program for the application of dental electrosurgery is presented. Exercises on muscle tissue and pig jaws are suitable to get informations of the proper adjustment of the units as well as the treatment procedures. The necessity of proper handling is illustrated by the results of wrong manipulations. Better understanding of the facts during electrosurgery enables the dentist to avoid adverse effects in treating his patients.

Animals↗

PubMed1982

Tissue dilation during multiple cast restorative techniques.

The advantages and disadvantages of three tissue dilation methods are discussed. There are distinct, identifiable advantages in selecting electrosurgery as the method, since the disadvantages to each method are essentially equal. Electrode use and type are recommended for tissue dilation for the anterior and posterior areas of the mouth. The fully rectified surgical current is suggested since it provides a clean excision of the tissue and controls hemorrhage with a thin layer of coagulum. Illustrations demonstrate electrosurgical techniques with specific electrodes for both anterior teeth and posterior teeth. The margins for full coverage preparation can be finished to the crest of the tissue and a subgingival tissue trough established to the desired depth. This provides a space to refine the preparation margins to the desired sulcular depth prior to making the elastic impression. A number of clinical examples demonstrate effective and safe electrosurgical tissue dilation. Several cases illustrate the combination of tissue recontouring along with tissue dilation. Discipline application of electrosurgery for tissue removal is safe and provides excellent results. This benefits both the patient and the dentist.

Bicuspid↗

PubMed1979

Electrodesiccation and fulguration of lesions of the skin.

Electrosurgery--electrodesiccation, fulguration, and electrocoagulation--is a simple and relatively inexpensive modality for treatment of small skin lesions, whether benign or malignant. The technique is easily mastered, and the results, with proper selection of patients, compare favorably with the results of scalpel-and-suture surgery. Electrosurgery does not mean "burning off" lesions and biopsy of the lesion is an integral part of the technique.

Basal Cell Carcinoma↗

PubMed1994

[Laparoscopic cholecystectomy: heat damage to the liver caused by hooked electrode and laser].

To control heat damage in the liver after cholecystectomy caused by electrosurgery or Laser, gallbladders were resected at autopsy partly by the Holmium:YAG-Laser and Nd:YAG-Laser and partly by electrosurgery. Heat damage was documented by histological examinations of the liver-bed of the gallbladder. Microscopical evaluation showed that electrocautery tends to produce deeper heat damage in the liver-tissue than the Holmium:YAG-Laser.

Burns↗

PubMedDate not supplied

Monopolar current, with particular attention to hook dissection in laparoscopic cholecystectomy.

Monopolar current has been part of surgical practice for decades. The introduction of laparoscopic surgery has led to new developments in electrosurgery, in instrumentation and in operative techniques. The hook electrode is a device specially created for laparoscopic surgery. Some essentials of modern electrosurgery and the technique of the hook electrode are reviewed, with special emphasis on its use during laparoscopic cholecystectomy.

Cholecystectomy, Laparoscopic↗

PubMedDate not supplied

[Management of surgery patients with implanted cardiac pacemakers].

Patients having cardiac pacemaker implanted may be subjected to various general surgery procedures. Application of electrosurgery for the purpose of resection and coagulation, provides a high frequency electric field which produces electric voltage on the electrodes of the pacing system. This voltage may be detected within the pacing system, and various arrhythmias can be provoked in correlation with underlying rhythm and mode of pacing. Preoperative patient control and proper pacemaker programming can prevent the pacing malfunctions due to the electrosurgery application. Appropriate positioning of the neutral electrode in relation to the pacing system avoids the electric fields intersection and decreases their interference.

Arrhythmias, Cardiac↗

PubMed1996

[Clinical, surgical and diagnostic evaluation of lesions of the oral mucosa using biopsy and histological studies: comparison of two methods].

In this study, the authors evaluated the clinical and histologic efficacy of electrosurgery (DTC 100) in performing excisional biopsy on benign mucosal lesions, in comparison with traditional surgery (scalpel and suture). For this aim, 40 biopsy specimens were selected and divided into 4 distinct groups: group A1, samples of oral lesions located on the genian mucosa and removed using DTC 100; group A2, samples of healthy genian mucosa removed using DTC 100, as control; group B1, samples of oral lesions located on the genian mucosa and removed using traditional surgery; group B2, samples of healthy genian mucosa removed using traditional surgery, as control. The clinical evaluation was carried out regarding symptomatology and bleeding after surgery, healing time, restitutio ad integrum. It gives positive results for the electrosurgical technique, in which the suture is not necessary. The histologic evaluation regarding the microscopical adequacy of specimens removed by means of electrosurgery shows better results than those from other authors; in fact, the presence of the cauterized margin compromize minimally the possibility of examining specimens of adequate size; the dimension of the cauterized margin also depends on various factors: the use of only the tomic function of the electroscalpel with the correct setting; the skill of the surgeon who should apply neither pressure or resistance; the speed of incision; the use, when possible, of acicular and thin blades.

Adult↗

PubMed1986

Transducer offset by electrocautery resulting in erroneous blood pressure measurement.

During a coronary artery bypass operation arterial blood pressure measured with a Bentley Trantec model 800 transducer increased erroneously while continuous electrocautery was being used. This phenomenon has recurred infrequently, with fictitious hypotension being observed in one patient. To reproduce the problem of pressure offset during electrosurgery a bench test demonstrated that with peak to peak voltage of 20 volts from the electrosurgical unit, three of seven Bentley transducers had offsets as much as +/- 50 mmHg. It is important for anaesthetists to determine if electrosurgery units are functioning before treating apparent pressure drifts.

Blood Pressure Determination↗

PubMed1999

Ultrasonic dissection for endoscopic surgery. The E.A.E.S. Technology Group.

With the development of endoscopic surgery, new hazards of high-frequency (HF) electrosurgery have been recognized. The potential risks of monopolar electrosurgery, the limitations of bipolar technique, and the need to reduce instrument interchange have favored the use of ultrasonic technology, which becomes more and more popular. This work aims at presenting the main features of the currently available ultrasonically activated scalpels, as well as their advantages, limitations, and indications.

Dissection↗

PubMed1996

The risk of carbon monoxide poisoning after prolonged laparoscopic surgery.

OBJECTIVE: To evaluate whether thermal energy produced by laser and bipolar electrosurgery during laparoscopic procedures significantly elevates blood carboxyhemoglobin levels. METHODS: We prospectively studied 27 healthy nonsmoking patients, mean +/- standard deviation (SD) age 39.1 +/- 8.0 years (range 22-56), scheduled for laparoscopic procedures in which smoke was generated. Prolonged operative laparoscopy involved high-flow carbon dioxide insufflation, intensive evacuation of intra-abdominal smoke, and controlled hyperventilation with 50-100% oxygen. Laser and bipolar electrosurgery were used in all cases. Blood samples were drawn before and after surgery. Carboxyhemoglobin concentrations were measured using a highly accurate gas chromatography method. RESULTS: The mean +/- SD duration of surgery was 141 +/- 72 minutes (range 45-300). The mean +/- SD carboxyhemoglobin levels were 0.70 +/- 0.15% (range 0.44-1.20%) before surgery and 0.58 +/- 0.20% (range 0.30-1.33%) after surgery. A significant decrease (P < .001) in carboxyhemoglobin concentrations occurred during surgery (mean +/- SD, 20 +/- 11%; range 3-46%). The carboxyhemoglobin level was increased at the end of surgery in only one woman. In only one patient did the levels exceed 1% (1.33%), still well below the human threshold tolerance level of 2%. The Spearman correlation coefficient between carboxyhemoglobin concentrations and duration of surgery was r = 0.308 (P = .12). CONCLUSION: Carbon monoxide (CO) poisoning is not associated with even prolonged laparoscopic surgical procedures. This may be attributed to aggressive smoke evacuation that minimizes exposure to CO, and to active elimination of CO by ventilation with high oxygen concentrations.

Adult↗

PubMed1991

Low conductivity irrigating solutions for arthroscopy.

The purpose of this study was to find a nonconductive physiologic solution to use for arthroscopy when electrosurgery is performed. We studied the effect of several solutions on proteoglycan synthesis in bovine articular cartilage slices, and the effect of using an electrosurgical instrument in various solutions in bovine knee joints. Both HEPES buffer 0.3 M (N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid) (Sigma Chemical Company, St. Louis, Missouri) and glycerol 2.6% gave good results in both categories. The glycerol solution appears to be the best from those tested since it supported cartilage metabolism somewhat better and is far less expensive than HEPES solution. Thus, in the use of electrosurgery during arthroscopic procedures, solutions such as Ringer's lactate and saline are too conductive to be effective or safe. Distilled water is nonphysiologic. Glycerol 2.6% is safe and effective and supports articular cartilage metabolism reasonably well for up to 2 h.

Animals↗