Introduction
140 Electrosurgery
Sheldon V. Pollack
Chapter Contents
Indications/Contraindications �.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��2444
Preoperative History and Considerations �.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��2444
Description of Techniques �.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��2445
Variations/Unusual Situations �.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��2447
Postoperative Care �.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��2448
Complications �.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��2448
Electroepilation �.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��2449
Iontophoresis �.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��2449
Future Trends ��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��.��2449
Synonym: Radiosurgery (historical)
Key features
Electrosurgery encompasses a group of procedures by which tissue is removed or destroyed through the application of electrical energy
True electrocautery uses direct current to create a red-hot tip, which can be safer for patients with pacemakers and implantable cardioverter-defibrillators
In modern electrosurgery, high-frequency alternating current is converted to heat within the treated tissues as a result of resistance to its passage
Electrodesiccation is superficial ablation by touching the tissue with a monoterminal device
Electrofulguration is superficial ablation via the use of a
monoterminal device whose electrode is held at a slight distance from the tissue, allowing a spark to jump to the tissue
Electrocoagulation uses a biterminal device for deeper coagulation
Electrosection uses a biterminal device to cut while achieving hemostasis by mild lateral heat spread
In order to minimize adverse sequelae, lateral heat spread should be kept to a minimum by using the appropriate waveform, power setting, and electrode size