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At least 145 records · Page 8Linked to original sources
PubMed2005

Battling blood loss in neurosurgery: Harvey Cushing's embrace of electrosurgery.

For his pioneering spirit, definitive work, and unparalleled devotion to conquering neurosurgery's toughest obstacles, Harvey Williams Cushing inarguably has earned the title, "The Father of Neurosurgery." His revolutionary incorporation of electrosurgical techniques in neurosurgery was not exceptional, but part of a pattern of recognizing, embracing, and establishing the use of medical technologies with great potential. Until 1910, Cushing had systematically reduced neurosurgery's primary complications--infection and the effects of intracranial pressure--to decrease mortality rates. Hemostasis had always been a concern of William Halsted's surgical protégé, but only after 1910 could Cushing primarily focus on it. In fact, Cushing's crucial collaboration with William T. Bovie and his electrosurgical apparatus conquered this major obstacle in 1926. The nature of their collaboration--two experts in their respective fields who were passionate about their work, working side by side in the operating room--resulted in progress that surpassed all predecessors in the field. Cushing never did learn the physics behind one of the most important advances of his career. Nonetheless, he did know that by greatly reducing blood loss, electrosurgery allowed him to operate in patients whose tumors had been previously deemed inoperable and on the entire spectrum of neurosurgical patients more safely.

Blood Loss, Surgical↗
PubMed2000

[Treatment of giant vulvar condylomata acuminata combining CO2 laser and electrosurgery].

Since no antiviral treatment exists for human papilloma viruses (HPV), the clinician's role is to treat all detectable lesions in order to help the patient's immune system fight the virus and to prevent transmission by contact with lesions. HPV-associated lesions have been treated by a wide range of modalities, which may be divided into chemical, surgical and immunity-stimulating methods. We treated patients with large vulva lesions with Electrosurgery in combination with laser CO2 vaporization. HPV-associated lesions have been treated by a wide range of modalities, which may be divided into chemical, surgical and immunity-stimulating methods.

Combined Modality Therapy↗
PubMedDate not supplied

Use of electrosurgery and lasers in the presence of dental implants.

Use of electrosurgery or laser surgery in the presence of metallic implants has been implicated in generating heat-induced injury to peri-implant bone, with the subsequent loss of osseointegration. Studies involving lasers offer conflicting results, while in the case of the electrosurg, little research has been published supporting or refuting these claims. This study measured local heat effects created by use of a unipolar electrosurgical unit, a bipolar electrosurgical unit, and a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Absolute temperature increase was measured during an in vitro uncovering surgical procedure performed with each unit. Analysis of variance for repeated measures was performed. Second, absolute temperature increase for each unit was compared with a theoretical clinical limit of a 10 degrees C increase. The findings suggest that use of the unipolar electrosurgical unit should be avoided, while judicious use of both the bipolar unit or the laser unit should produce temperature profiles well within clinical limits.

Aluminum Silicates↗
PubMed2003

The prevention of fire during oropharyngeal electrosurgery.

We report the results of our study of 25 children who underwent tonsillectomy and/or adenoidectomy under endotracheal general anesthesia with respect to their risk of fire in the oropharynx. We also attempt to explain the reasons for the difference between the relatively high incidence of airway explosions and fires that have occurred during tracheostomy with electrosurgery and electrocautery and the low incidence of these events during electrosurgical dissection of the tonsils. Finally, we review the precautions that physicians can take to lower the risk of operating-room fires and explosions.

Child↗
PubMed2005

Thermal injury due to electrosurgery.

Since the electrosurgical instruments are commonly used in a wide variety of surgical specialties, understanding of the properties of these instruments is very important to prevent the potential complications. We report the case of a patient who sustained a third-degree dermal burn caused by contact with the ground plate of the electrosurgical system. This burn healed with surgical treatment. Since electrosurgery causes serious complications, surgeon and operating suite personnel should pay attention to the electrosurgical system during the operation. Additionally, patients must be informed about these complications.

Burns, Electric↗
PubMed1991

Electrosurgery thermal injury. Myth or misconception?

Two sets of experiments were conducted to determine whether the potential hazards of secondary sparking and distal tissue burns are a serious risk for surgeons using monopolar electrosurgery during laparoscopy. The results indicate that secondary sparking poses little threat, whereas distal burns are very likely, given certain tissue parameters that force the entire electric current through narrow structures.

Animals↗
PubMed2006

[Electromagnetic hazards from electrosurgery--assessment of occupational exposure to electromagnetic field and currents induceed in the body].

The investigation of the occupational exposure to electromagnetic fields from electrosurgery devices were done (according to the requirements of Polish Standard PN-T-06580:2002). The exposure was evaluated following the criteria established by occupational safety and health regulations. The measurements and evaluation of the currents flowing through the exposed workers body were also conducted following the method and criteria published by IEEE standard and European Directive 2004/40/EC. It was found that in the vicinity of electrosurgical devices, the area of electromagnetic fields to which only workers operating the source of field should be exposed can exist up to the distance of 70 cm from the active electrode and supplying cables. In the case when the cables are placed directly on the surgeon body or long duration of the daily exposure the overexposure of workers can appear (referring to Polish regulations). The current flowing through the arm of surgeon keeping the electrode with electric field of the maximum strength (app. 1000 V/m or higher) can exceed permissible value of 40 mA established by the Directive 2004/40/EC for contact current. The reduction of the surgeon exposure can be reached by the proper positioning of the cables supplying monopolar electrode or by the use of bipolar electrode.

Electric Conductivity↗
PubMed1988

Arthroscopic lateral retinacular release using a modified superomedial portal, electrosurgery, and postoperative positioning in flexion.

A technique for utilizing a modified superomedial portal, 6 cm proximal to and in line with the medial edge of the patella, is described for observing patellar tracking and performing a lateral retinacular release. The lateral release is performed without tourniquet using electrosurgery, and the knee is positioned in 90 degree flexion for two days postoperatively. The technique was used in 53 patients with lateral patellar and soft tissue tenderness and pain, 31 of whom had lateral patellar subluxation documented on 45 degrees Merchant x-ray views. Patients with a history of dislocation or a Q angle of more than 18 degrees were excluded. Conservative treatment averaged seven months pre-operatively. Results in 75% of the patients (37 knees) were rated good or excellent at an average follow-up of 20 months. One postoperative hemarthrosis occurred. This technique facilitates patellar evaluation and lateral release under direct vision using the same portal, as well as permitting early range of motion postoperatively.

Adolescent↗
PubMedDate not supplied

Electrical impedance properties of the body and the problem of alternate-site burns during electrosurgery.

The radiofrequency (RF) impedance at 500 kHz was measured between multiple contact points on the bodies of six healthy volunteers by a tetrapolar measurement technique. The impedance between various contact points was predictable and could increase by a factor of two, depending on the sites selected for electrode application. These results were related to a simple resistive model of RF current distribution through the body. Based on the model and on data from human subjects, a hierarchy of optimal locations was developed to minimize the impedance between a surgical site and a dispersive electrode site and to reduce the potential for alternate-site burns from electrosurgery.

Adolescent↗
PubMed1982

Broader horizons and indications for use of electrosurgery in oral surgery.

Electrosurgery offers oral surgery many unique, invaluable advantages. Hemostasis obtained with fully rectified cutting current, scar-free healing of electrosurgical wounds by granulation secondary repair as well as by primary intention, the ability to perform precise tissue cutting without the use of manual pressure, and sterilization of the surgical field are especially noteworthy advantages. Atraumatic tissue cleavage and sterilization of the wound eliminate and unfavorable postoperative sequelae common to scalpel surgery and contribute materially to rapid, uneventful postoperative healing. The ability to incise tissue precisely without use of pressure and effective hemostasis make possible sophisticated oral surgery procedures that cannot be duplicated safely by scalpel surgery.

Drainage↗
PubMed1993

Experimental treatment of eyelashes with high-frequency radio wave electrosurgery.

Apart from mechanical epilation, which is a nuisance to both the patient and the ophthalmologist, standard techniques for removing unwanted eyelashes, such as electrosurgery (Hyfrecator) and cryosurgery, may cause eyelid tissue damage and other complications. Refinements in electrosurgical techniques have enabled production of a machine that can provide high-frequency radio waves with a modification of the waveform to produce a blended cut-coagulation effect (Ellman Surgitron). Treatment of hairs in fresh calf skin with the Ellman Surgitron resulted in destruction of the germinal cells of the hair follicle, with only a small amount of tissue change lateral to the track of the electrode; the Hyfrecator caused total sloughing of the epithelial cells, with marked superficial tissue changes due to heat spread. In six eyelids of six patients undergoing eyelid excision the Ellman Surgitron was effective in causing destruction of the germinal cells of the hair follicle, with very little lateral heat spread in the tissues or destruction of the skin epithelial cells. As well, there was no tissue damage anywhere near the conjunctival surface.

Animals↗
PubMed1997

[Electrosurgery as treatment of high grade squamous intraepithelial lesions of the cervix].

A prospective study was realized with the purpose of evaluating the efficiency of the excisional therapy of the electrosurgery in the treatment of the High Grade Squamous Intraepithelial Lesion (H.G.S.L.I.) of the cervix. 149 patients who were attended at the colposcopy service with this diagnosis were selected during September 1990 to April 1993. The procedure was realized in 37 patients 24.8% in the operating room and in 112 patients (75.2% in the outpatient room with local anaesthesia. With this last mentioned method in 93.8% not one type of trouble was presented, referring only a slightly to moderate pain in 6.2%. The transoperatory complications were bleeding on the surgical site in 3.3% which was solved at the moment through local electrocoagulation, and late bleeding present in 4.2% of the patients. The lesion was completely eliminated when the deepness of the cone corresponded to 1.81 cm in 139 cases (93.29%). Through a colpo-cytologic follow-up in 24 months, a persistence of the virus of the human papilloma was shown in 5.5% during the first nine months and appearance of one case of H.G.S.I.L. after 18 months. Therefore, these results had a therapeutic efficiency of the global follow-up of 90.08%.

Adolescent↗
PubMed1998

[The use of electrosurgery in the treatment of extra-cervical genital condylomatosis].

BACKGROUND AND AIMS: The aim of this study was to evaluate the therapeutic efficacy of electrosurgery in the treatment of HPV correlated extra-cervical genital lesions. METHODS: A group of 78 patients with clinical or colposcopic, histologically ascertained vulvar or perineal condylomatosis were enrolled consecutively between March 1994 and July 1995 at the Cervico-Vaginal and Vulvar Pathology Unit of the Obstetrics and Gynecology Clinic at Tor Vergata University, Rome. All patients underwent physical treatment with a radiofrequency electrosurgical knife using exclusively cutting current. In addition to patient compliance, the following parameters were evaluated: length of surgery and recovery times, collateral effects and possible long-term results; a colposcopic and, if necessary, bioptic follow-up was also performed at 3, 6 and 12 months after treatment. RESULTS: Seven out of the group of 68 patients with subclinical condylomatosis presented histologically documented recidivation during the course of follow-up. In the discussion the authors evaluate the positive results obtained using this method and, based on the physical principle underlying electroradiosurgery, they suggest using the term electrosurgical vaporisation for destructive electrotherapy using a cutting current, which is suited to the physical mechanism with which this current acts.

Condylomata Acuminata↗
PubMed2002

Tonsillectomy by means of plasma-mediated ablation: prospective, randomized, blinded comparison with monopolar electrosurgery.

OBJECTIVE: To compare plasma-mediated ablation (PMA) with monopolar electrosurgery (MES) for pediatric tonsillectomy. DESIGN: Prospective, randomized, blinded study. SETTING: Academic children's hospital. PARTICIPANTS: Thirty-four children, aged 4 to 7 years. INTERVENTIONS: Tonsillectomy by means of PMA (n = 17) or MES (n = 17). OUTCOME MEASURES: We measured surgical efficacy, estimated blood loss, and surgical time during tonsillectomy and morphine use, immediate postoperative pain, and recovery scores after tonsillectomy. Parents recorded recovery of normal diet and activity and their own return to work for 10 days after surgery. Histopathologic evaluation of excised tonsils was performed. We reviewed medical records and attempted follow-up telephone contact. RESULTS: With no significant difference in blood loss compared with MES, PMA was effective for tonsillectomy. Performance of PMA took longer (24 vs 16 minutes; P =.002). Results of histopathologic evaluation showed less thermal injury with PMA than with MES (P =.03). Morphine consumption, pain, and recovery scores were equivalent between groups. We found no significant difference in recovery of normal diet and activity or parental return to work. Patients undergoing PMA had a greater number of perioperative complications than those undergoing MES, including 2 patients in the PMA group (compared with none in the MES group) who required unplanned admission for postoperative airway obstruction. CONCLUSIONS: Plasma-mediated ablation for pediatric tonsillectomy resulted in less histopathologic thermal injury than MES, but did not show a statistically faster recovery to normal activity and diet or parental return to work. In addition, PMA took longer to perform, and had more complications. Therefore, PMA should not replace MES for pediatric tonsillectomy. The reduced thermal injury with PMA supports investigation into other means of using plasma ablation to treat tonsillar hypertrophy.

Child↗
PubMed1983

Electrosurgery and cardiac pacemakers.

There are two basic types of cardiac pacemakers: (1) Fixed-rate pacemakers stimulate the heart at a regular rate independent of the intrinsic heart rate. (2) Demand pacemakers sense the heart's spontaneous rhythm. They are more commonly used because they are noncompetitive with the heart. There are two varieties of demand pacemakers: ventricular-inhibited and ventricular-triggered. Their responses to electrical interference are quite different. Potential pacemaker interference is a consideration with high-frequency electrosurgery. The problems with electrosurgical interference have occurred primarily with early pacemaker models. Recent improvements in electrical shielding and filtering systems have made pacemakers very resistant to outside electrical influence. Simple electrodesiccation of small lesions on relatively healthy pacemaker patients poses negligible risks. Caution is advised for marginal patients undergoing extensive electrosurgical procedures. The potential risks are further minimized by proper attention to patient history, monitoring, proper grounding, the avoidance of cutting current, and the use of proper technic.

Arrhythmias, Cardiac↗
PubMed2000

Electrocautery and electrosurgery.

Electrocautery and electrosurgery can reduce the amount of time an animal is under anesthesia, as well as minimize the extent of tissue damage. Used correctly, these techniques conserve time and reduce animal stress.

Journal Article↗
PubMed1987

Potential ocular damage from microwave exposure during electrosurgery: dosimetric survey.

A dosimetric survey of microwave radiation emitted by electrosurgical units used in operating rooms indicated that surgeons expose themselves to levels that may be hazardous, and that ocular exposures are especially high: 20 cm from the active lead, electric field strength at the eye/forehead position was 9.0 X 10(6) V2/M2 for the monopolar unit; and magnetic field strength at this position reached a magnitude of 3.5 A2/M2. These electric and magnetic fields exceeded the TLVs of the American National Standards Institute. The authors concluded that the high levels of microwave radiation generated by electrosurgery devices should receive immediate attention to assess health effects associated with such exposures.

Electrocoagulation↗