Electrosurgical Unit

1. Without reference, identify principles about Electrosurgical Units with at least 70 percent accuracy.

2. Electrosurgical Unit • Purpose of an Electrosurgical Unit (ESU) • A system that uses radio frequency to • Sever tissue • Stop bleeding (hemeostasis) • Units operate in the range of 300 kHz to 3 MHz

3. Electrosurgical Unit • Types • Monopolar • Active electrode - one side of the generator • The electrosurgical effect takes place at the active electrode only • Typically offers the best alternative for wide surface coagulating and dissection of tissue • Return electrode • The other side is known as • patient plate • Reference electrode • dispersive electrode

4. Electrosurgical Unit • No electrical effect is intended or desired • Needed to complete the electrical circuit • Placement • As close as possible to the surgical site • Minimize the distance that the current will need to travel through the body • Bipolar • Both sides of the generator are connected to a surgical handpiece • Allows for better current control • The current passes between two poles of a forceps rather than through the entire body

5. Electrosurgical Unit • Surgical Effects and Operational Modes • Coagulation • Used to control or stop bleeding • It is a low power technique • Uses an interrupt current to supply controlled dehydration • Can also be used for destroying undesirable tissue masses • Cutting • Heats tissue so rapidly that cells explode and contents vaporize leaving an incision • When used, the electrode is separated from the tissue by a thin layer of steam • Used like a stainless steel scalpel • Little or no control over bleeding

6. Electrosurgical Unit • Blend • Hybrid of cut and coagulate • Used when surgeon desires more hemeostasis effect than cut provides • This mode saves time, as only one pass with electrode is necessary • Spray (fulguration) • Used for rapid control of bleeding across a wide area • A non-contact type of coagulation • The current sparks or jumps from active electrode to the tissue • Uses • To destroy surface layers of cells in the bed from which a lesion has been removed • Ideal for sealing off hidden bleeders due to their path of least resistance

7. Electrosurgical Unit • Power • Can be varied for all modes • Setting depends on tissue type, procedures, and the type of electrode used • Low power • Neurosurgery • Oral • Medium power • General surgery • Abdominal opening • High power • Open the chest • Mastectomies

8. Electrosurgical Unit • Precautions • Return plate burns • Protect the patient from being burned • The pad must have as much direct contact with the patient as possible • Edge effect – use a pad that has a larger edge to lower current density • Monitor Systems • Used to prevent a patient from a pad related burn • The ESU is designed to send a small current up one side of the pad through the patient’s skin and back through the other side of the pad • If the ESU senses a change in resistance from the pad to patient contact it will set off an alarm

9. Electrosurgical Unit • Alternate current path burns • When the pencil is activated there is opportunity for RF leakage interference • Wrapping surgical cable around metallic material and securing it to a flammable material may lead to a fire hazards • You need to be aware of the hazards of RF leakage and choose products that are shielded properly from these hazards • Prevent electrical shock • Know the basic principles of electricity, current density, and the path of least resistance • Never activate in open circuit