Electrosurgery

Taheri, Arash; Mansoori, Parisa; Sandoval, Laura F.; Feldman, Steven R.; Pearce, Daniel J.; Williford, Phillip M.

doi:10.1016/j.jaad.2013.09.055

Cited by 46 publications

(33 citation statements)

References 67 publications

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“…Electromagnetic signal, including RF, induces an electrothermal reaction in targeted tissues, the patterns of which depend on the resistance of the tissue 1 . RF energy can be emitted into the skin either non- or invasively via a monopolar mode that utilizes an active electrode and a grounded electrode or via a bipolar mode that employs two active electrodes 2 . In monopolar modes, an electrical circuit formed by an electron current that flows from the active electrode to the grounded electrode is generated in the patient’s body 2 .…”

mentioning

confidence: 99%

“…RF energy can be emitted into the skin either non- or invasively via a monopolar mode that utilizes an active electrode and a grounded electrode or via a bipolar mode that employs two active electrodes 2 . In monopolar modes, an electrical circuit formed by an electron current that flows from the active electrode to the grounded electrode is generated in the patient’s body 2 . Meanwhile, bipolar electrosurgery systems induce an electrical circuit between the two active electrodes that is limited to regionally targeted tissues 2 3 .…”

mentioning

confidence: 99%

“…In monopolar modes, an electrical circuit formed by an electron current that flows from the active electrode to the grounded electrode is generated in the patient’s body 2 . Meanwhile, bipolar electrosurgery systems induce an electrical circuit between the two active electrodes that is limited to regionally targeted tissues 2 3 . In the skin, these active electrodes emit an electron current that flows through the shortest path in the target tissue between the electrodes, theoretically limiting the depth of the thermal response induced by the electromagnetic energy 2 .…”

mentioning

confidence: 99%

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Electromagnetic Initiation and Propagation of Bipolar Radiofrequency Tissue Reactions via Invasive Non-Insulated Microneedle Electrodes

Zheng

Dannaker

et al. 2015

Sci Rep

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Radiofrequency (RF) energy can be emitted into the skin, either non- or invasively, via a monopolar mode that utilizes an active electrode and a grounded electrode or via a bipolar mode that employs two active electrodes. In this experimental study of RF tissue reactions, bipolar RF energy was emitted in vivo to micropig skin at varying microneedle penetration depths, signal amplitudes, and conduction times. Immediately after RF treatment, skin samples exhibited RF-induced coagulation columns of thermal injury, separately generated around each microneedle in the dermis. In ex vivo bovine liver tissue, the thermal coagulation columns were found to be concentrated maximally around the pointed tips of each electrode. After a RF conduction time of 2 seconds, the individual areas of thermal coagulation began to converge with neighboring RF-induced coagulation columns; the convergence of coagulation columns was found to start from the tips of neighboring electrodes.

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Electromagnetic Initiation and Propagation of Bipolar Radiofrequency Tissue Reactions via Invasive Non-Insulated Microneedle Electrodes

Zheng

Dannaker

et al. 2015

Sci Rep

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“…Therefore, complications are often related to connection problems and surgical mistakes, rather than electrosurgical generators [8, 16, 18]. To improve the efficacy and safety of these surgical procedures, it is crucial to understand these technologies and applications [19].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Thermal Spread of Three Different Electrosurgical Generators on Rat Uterus: A Preliminary Experimental Study

Karacan

Usta

Ozkaynak

et al. 2018

Gynecol Obstet Invest

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Background/Aims: The objective of this study was to compare the depth and width of thermal spread caused on rat uterine tissue after application of 3 different electrosurgical generators. Methods: Alsa Excell 350 MCDSe (Unit A), Meditom DT-400P (Unit M), and ERBE Erbotom VIO 300 D (Unit E) electrosurgical units (ESUs) were used. The number of Wistar Hannover rats required to obtain valid results was 10. The primary objective of the study was to compare the 3 ESUs using the same instrument and the same waveform. The secondary objective of the study was to compare the differences between monopolar and bipolar systems of each ESU separately using the same waveform. Results: The thermal spread caused by each ESU using monopolar instruments with continuous and interrupted waveforms was significantly different. Among the 3 devices, Unit A caused the largest thermal uterine tissue spread. On the other hand, Unit E caused the most superficial thermal tissue spread, and the smallest thermal spread among all ESUs. Conclusions: Surgeons should note that different ESUs used with the same power output might create different thermal effects especially in the monopolar configuration within the same waveform, for the same duration, and with the same instrument.

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“…Based on observations in clinical practice and literature, power settings ranging from 40 to 80 W with 10-W increments were used. [40][41][42] Each power setting/tissue type/electrosurgical combination was applied 10 times.…”

Section: Electrosurgical Treatment Of Tissuementioning

confidence: 99%

Real-time oncological guidance using diffuse reflectance spectroscopy in electrosurgery: the effect of coagulation on tissue discrimination

et al. 2018

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In breast surgery, a lack of knowledge about what is below the tissue surface may lead to positive tumor margins and iatrogenic damage. Diffuse reflectance spectroscopy (DRS) is a spectroscopic technique that can distinguish between healthy and tumor tissue making it a suitable technology for intraoperative guidance. However, because tumor surgeries are often performed with an electrosurgical knife, the effect of a coagulated tissue layer on DRS measurements must be taken into account. It is evaluated whether real-time DRS measurements obtained with a photonic electrosurgical knife could provide useful information of tissue properties also when tissue is coagulated and cut. The size of the coagulated area is determined and the effect of its presence on DR spectra is studied using ex vivo porcine adipose and muscle tissue. A coagulated tissue layer with a depth of 0.1 to 0.4 mm is observed after coagulating muscle with an electrosurgical knife. The results show that the effect of coagulating adipose tissue is negligible. Using the fat/water ratio's calculated from the measured spectra of the photonic electrosurgical knife, it was possible to determine the distance from the instrument tip to a tissue transition during cutting. In conclusion, the photonic electrosurgical knife can determine tissue properties of coagulated and cut tissue and has, therefore, the potential to provide real-time feedback about the presence of breast tumor margins during cutting, helping surgeons to establish negative margins and improve patient outcome.

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Electrosurgery

Cited by 46 publications

References 67 publications

Electromagnetic Initiation and Propagation of Bipolar Radiofrequency Tissue Reactions via Invasive Non-Insulated Microneedle Electrodes

Electromagnetic Initiation and Propagation of Bipolar Radiofrequency Tissue Reactions via Invasive Non-Insulated Microneedle Electrodes

Comparison of the Thermal Spread of Three Different Electrosurgical Generators on Rat Uterus: A Preliminary Experimental Study

Real-time oncological guidance using diffuse reflectance spectroscopy in electrosurgery: the effect of coagulation on tissue discrimination

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