Electrosurgical generators (ESGs) are currently the most widely used surgical technology for clinical operations. The main disadvantage of ESGs is their output power is irregular due to the variable tissue impedance. The heat dissipation caused by the high amount of thermal energy generated leads to medical complications for both patient and surgeon. In this research, various inverter topologies and power controllers are investigated to specify the best structure that ensures best performance. The type of inverter topologies investigated are three level and five level, while the PID structures investigated are integer order (IO-PID) and fractional order (FO-PID). The simulation results indicate that FO-PID with five level inverters is better than IO-PID with three level inverters in terms of minimum heat dissipation rate and THD of the output voltage and current.