Electrosurgical instruments: How to choose the right equipment for minimally invasive surgery?

What is electrosurgery and how is it used in minimally invasive surgeries?

Electrosurgery is a method of surgical intervention in medicine, which is based on the destruction of body tissues with the help of alternating current. Its frequency ranges from 200 kHz to 5.5 MHz. Electrosurgery devices are used in neurosurgery, thoracic, abdominal, pediatric surgery, urology, gynecology, dermatology, dentistry, aesthetic medicine and other areas.

Exposure to high-frequency current causes instant evaporation of intracellular fluid due to the thermal effect. Intense vaporization contributes to the melting and welding of blood vessels, which provides hemostasis. High-frequency surgery is used during 85% of operations. The equipment allows to perform:

• tissue cutting;

• coagulation;

• vascular electrolysis;

• devitalization.

The cutting effect of the electrosurgical device appears due to the formation of electric arcs. As a result, the incision has a coagulation zone around the edges. Coagulation causes tissue heating up to 60-100 °C, evaporation of intracellular fluid without disturbing the cellular structure, provides hemostasis of the cut vessels. Thermoligation is used for sealing small vessels and melting tissue layers. Devitalization refers to the targeted destruction of pathological foci and neoplasms. Under the influence of high-frequency current, the affected tissue gradually breaks down due to metabolic processes.

Types of electrosurgical instruments

Electrosurgical instruments are specialized medical devices available in various shapes and sizes for surgical procedures, including cutting and coagulation. Specialists use the main types of electrosurgical instruments, such as:

1. Monopolar electrodes — consist of thin metal wire, used for cutting and coagulation.

2. Bipolar forceps — deliver electric current using two metal tips, used for coagulation without a grounding pad.

3. Electrosurgical Pencil — a portable device that allows you to adjust the power and frequency of the electric current during surgery depending on the type of operation.

4. Laparoscopic, arthroscopic electrodes — deliver electric current through a small incision, inserted with a trocar, designed for minimally invasive surgical manipulation, dissection, coagulation.

5. LEEP-instruments — consist of a loop electrode, necessary for dissection of abnormal tissue, sealing of vessels, used in gynecology and obstetrics

Specialized training and practical experience of the physician are important for the safe and effective use of electrosurgical instruments. Nursing staff should have knowledge of the different types of instruments, their functions, potential risks, and possible complications.

Key characteristics of electrosurgical instruments

Electrosurgical equipment operates in two modes: monopolar and bipolar. The monopolar technique involves passing electrical current through the body from an active electrode to a passive electrode. This method is commonly used for tissue cutting and coagulation. The bipolar technique utilizes a single surgical instrument, where the two outputs of the generator are connected to active electrodes integrated into one design.

Modern medicine uses a wide variety of electrosurgical high-frequency devices. They differ in parameters, design features, modes, set of instruments, dimensions. In general surgery, universal multifunctional equipment of high power with a set of working tools and modes is often used. Narrowly focused devices have certain technical characteristics and are equipped with devices for the corresponding field of medicine.

Selecting electrosurgical equipment for different types of operations

When choosing electrosurgery instruments, it is important to determine for which manipulations they will be used:

1. Deep incisions, extensive dissections with simultaneous coagulation of vessels require the use of monopolar equipment.

2. Spot effects, small incisions, cauterization of large vessels during surgery are performed with bipolar devices.

3. Stopping bleeding from a large focus, minimally invasive reduction of neoplasms, laparoscopy, neurosurgery, cosmetic and endoscopic manipulations are carried out using a non-contact electrocoagulator. The device is a type of electrosurgical devices of monopolar type, allowing you to perform delicate operations.

Hybrid devices combine both monopolar and bipolar modes. Before purchasing the equipment, it is important to determine its intended use—whether for outpatient procedures or surgical interventions. The capabilities of the devices depend on their power output. Electrosurgical devices with a power range of 50-200 V are used for the removal of small neoplasms and minor incisions. For extensive dissections, soft tissue coagulation, and endoscopic or bronchoscopic surgery, devices with higher power, ranging from 200-400 V, are required.

The higher the frequency of electrosurgical equipment, the clearer the cut and the less pronounced the coagulation effect. Plastic surgery requires models with maximum frequency, as well as separate cutting and coagulation modes for fine cuts and cosmetic sutures. Coagulation is especially important for working with mucosa, so in otolaryngology and gynecology, devices with a frequency range of 350-500 kHz are commonly used. If a clinic performs a variety of operations, it is advisable to choose universal options with multiple modes. For procedures like biopsy, polypectomy, laparoscopy, and the removal of small neoplasms, devices with two modes—resection and coagulation—are typically used. Thanks to the smooth adjustment capability, the doctor can control the strength of the impact on the tissue.

It is important to determine the necessary set of electrodes. Stopping heavy bleeding is carried out with powerful tools. For tissue dissection are suitable thin — strings, loops. Most models of devices allow the simultaneous use of several electrodes.

Criteria for choosing a model

On the medical market there is a wide range of electrosurgical devices of high frequency. Each manufacturer produces models for different needs and capabilities of medical institutions. During the selection of a suitable option, attention should be paid to the parameters:

• power range;

• modes of operation;

• the number of connectors for mono- and bipolar instruments;

• availability of display and its type;

• dimensions, weight;

• safety, automatic inspection system;

• possibility to connect additional options;

• compatibility with endoscopic equipment;

• availability of consumables.

An electrosurgical instrument should be ergonomic and easy to use to reduce the risk of physician fatigue during operation and improve surgical results. On Bimedis Marketplace, customers can compare different models of devices from leading brands, read reviews and choose the most suitable option.

Conclusion

Modern medicine requires the use of high-performance, quality equipment. The combination of this equipment with the experience and high qualifications of doctors ensures the success of therapy. Electrosurgical devices offer many advantages and a variety of functions, making them indispensable for minimally invasive procedures. The key features of these devices include accuracy, speed, versatility, and safety. When selecting electrosurgical tools, it is important to consider not only the price but also the list of planned surgical interventions. Powerful, multifunctional models allow for a wide range of surgical manipulations, while basic models are suitable for a more limited set of procedures.