The use of cautery dates

back as far as prehistoric

times, when heated
stones were used to
obtain hemostasis.

William T Bovie - father

of electrosurgical
devices

Within the surgeon’s armamentarium,

electrosurgical devices stand out as
some of the most useful and most used
instruments
APPLICATIONS OF DIFFERENT CURRENT
FREQUENCIES
Electrosurgery: Electrocautery :
high-frequency electrical current
electrical current heats an
passed through instrument and a
tissue to create a clinical effect is
desired clinical realized when the
effect heated tool is
applied to the
tissues
 How does it work?
• The rate at which tssues are heated plays a crucial role
in determining clinical effect.
• When an oscillatng current is applied to tssue, the rapid
movement of electrons through the cytoplasm of cells causes
the intracellular temperature to rise.
• The amount of thermal energy delivered and the tme rate
of delivery will dictate the observed tssue effects.
• In general, below 45°C, thermal damage to tssue is
reversible.
• As tssue temperatures exceed 45°C (as in coblaton and RF),
the proteins in the tssue become denatured, losing their
structural integrity.
• Above 90°C, the liquid in the tssue evaporates, resultng in
desiccaton if the tssue is heated slowly or vaporizaton if the
heat is delivered rapidly.
• Once the tssue temperatures reach 200°C( as in laser or
cautery), the remaining solid components of the tssue are
reduced to carbon. which can cause granulatons, post op
infectons, morbidities like excessive scar tssue formaton.
 Types of electrosurgical instruments
Electrosurgical technology offers essentially
two types of devices for energy delivery:

monopolar and bipolar

The monopolar instrument
delivers current through an
Bipolar instruments
active electrode which then
resemble surgical forceps,
travels through the patient
with both the active
and back to the generator
electrode and the return
through a conductive
electrode functions being
adhesive grounding pad
performed at the surgical
applied to the patient
site
before beginning the
procedure