Electrosurgical units (ESUs) have greatly evolved in the 80 years since their introduction in the 1920s. The past two decades, however, have seen the greatest revolutions in electrosurgical technology with improvements in isolated units (in place of ground references), discrete output technology, tissue impedance monitoring, enhanced coagulation and tissue response at the active electrode. If youre not sure what each of these improvements means to your practice, or even what each of these improvements means at all, fear not: we here at Medical Equipment Update have composed the following series of posts to keep you abreast of the latest developments in electrosurgical technology and how they affect the generator your practice needs.
Applications
Just as weve seen new developments in electrosurgical technology over the past two decades, so too have we seen electrosurgery leave the traditional operating room environment and spread into the offices of dermatologists, plastic surgeons, gynecologists, ophthalmologists, urologists, otolaryngologists, dentists and family practitioners.
While it still remains a valuable tool in the hospital arena, the electrosurgical generator has become more accessible and more commonplace in smaller, more specialized practices. So being, the features and accessories available in this market have expanded greatly and todays buyers of electrosurgical equipment face a whole host of options previously unavailable in the market for ESUs.
Monopolar and Bipolar Operation
Many new electrosurgical units will facilitate two types of operation: monopolar and bipolar. In monopolar operation, the primary electrode is applied at the surgical site with a cutting power ranging from 100 to 400 watts. The energy leaves the body via a patient plate located somewhere else on the patients body. In contrast, bipolar operation requires only a fraction of the wattage (50-100) in order to accomplish the same caliber cut.
This discrepancy in power consumption can be attributed to the more focused nature of bipolar operation. With two electrodes often the tips of a pair of forceps or scissors the electrosurgical current is limited with greater control, confining the current to the immediate area surrounding the electrodes. This mode of operation eliminates the need for a patient plate and increases efficiency. Furthermore, it mitigates the potential for damage to sensitive tissue and patient burns.
Power Controls and Settings
Just as important as the delivery of an electric current is the proper maintenance of control over that current and the settings used to administer it. For instance, many older units have featured analog (dial) controls that inherently limit the precision of current delivery and leave a great deal of ambiguity regarding the units operational settings.
Newer units have remedied this by featuring digital control panels accompanied by numeric displays of current administration settings; thus allowing discrete manipulation of power and blend levels. For instance, the DRE ASG Series from DRE features LCD wattage displays and easy-to-read digital controls.
