Electrosurgery
Electrosurgery is a medical technique that utilizes high-frequency electrical currents to cut, destroy tumor cells, or cauterize soft tissue during surgical procedures. It is particularly effective in treating various cancers, especially skin and oral cancers. This method offers an alternative to traditional surgical techniques, which primarily involve sharp scalpels, and it is designed to reduce bleeding during operations. Electrosurgery is performed using specialized equipment that converts standard electric current into a safe alternating current, allowing for precise control over tissue impact.
Preparation for electrosurgery varies depending on the procedure, often requiring patients to avoid food or liquids prior to surgery, and possibly take antibiotics to minimize infection risks. While generally safe, electrosurgery does come with risks, including potential damage to surrounding tissues, significant blood loss, and complications related to anesthesia. Following the procedure, patients may need additional cancer treatments, such as chemotherapy or radiation, to ensure comprehensive care. The effectiveness and outcomes of electrosurgery can differ based on multiple factors, but it generally provides benefits such as reduced blood loss compared to conventional surgical methods.
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Subject Terms
Electrosurgery
ALSO KNOWN AS: Electrofulguration, fulguration, medical diathermy, surgical diathermy
DEFINITION: Electrosurgery is the use of electric current to cut, kill tumor cells, or cauterize soft tissue.
Cancers treated: A variety of cancers, especially those of the skin and mouth
Why performed: Surgeons have many options for removing cancerous growths or tumors. The most traditional method is to use a sharp metal scalpel to cut around the tumor and remove it. This is frequently the method in which surgeons were initially trained and with which they have the most experience. It also is often the most cost-effective. However, there can be significant bleeding during and after this type of procedure, and research scientists always try to identify new ways to better serve patients. One way that has been developed involves using a laser, while another is electrosurgery. Electrosurgery uses an instrument that gives off high-frequency alternating electrical current that heats cells and allows surgeons to cut with reduced bleeding. The same equipment can also be used for electrocautery to stop bleeding.
Patient preparation: The required patient preparation depends on the type of electrosurgery being done and the extent of the procedure. In many cases, the patient will be instructed to prepare similarly to preparations for other types of surgeries. This can include avoiding food and liquids for a specified period of time and may involve taking antibiotics to help prevent infection. Patients will generally be specially screened to ensure that they are good candidates for electrosurgery. Individuals with pacemakers or other devices may not be appropriate candidates because of the use of electrical current that flows through the patient’s body during the procedure.
Steps of the procedure: Electrosurgery is performed by a surgeon who has had extensive specialized training in using electrosurgical equipment and performing related procedures. The procedure is done using a special generator that takes regular electric current and converts it to electrical current that alternates at a frequency slightly lower than that of AM radio stations. This is done because the electrical current in normal use would result in damage to the patient, including possible nerve or muscle damage and even electrocution. Electrical current of the frequency used by electrosurgical devices is usually considered safe for most individuals, except for those with pacemakers or other implanted devices.
The surgeon uses a unique instrument through which the electrical current flows. The surgeon has several choices of voltage and frequency, which can be used to achieve various effects. The surgeon will usually start with the lowest possible power and increase it until the desired effect is achieved. The tip of the surgical instrument remains cool, but the energy is transferred to the surrounding cells. At low levels, this can cause water to leave the cells and the cells to dehydrate and shrivel. At higher levels, the water inside the cells heats enough to boil so quickly that it does not have time to escape, so the cell ruptures. The surgeon can use this instrument to make very thin and precise cuts, to heat tumors to destroy them, or to cauterize cells to stop bleeding, depending on the goal of the procedure.
After the procedure: After electrosurgery, the patient will generally be taken to a recovery room if the procedure was performed under general anesthesia. If there is a wound at an incision site, it must be cleaned and cared for regularly until healing is complete. In many cases, electrosurgery is not the only cancer treatment option being used in a patient’s comprehensive cancer care plan. If electrosurgery is used to remove a cancerous growth, then radiation therapy or chemotherapy may still be necessary to kill any cancer cells that remain after the majority are removed surgically.
Risks: Many of the risks associated with electrosurgery are the same or similar to those associated with traditional surgical methods. There is a risk of significant blood loss, pain, swelling, and infection. With electrosurgery, there is also some risk of damage to healthy tissues surrounding the cancerous tissue. Because electrosurgery is usually performed under general anesthesia, there are also the risks associated with anesthesia, such as negative cardiovascular events or allergic reaction. There is some risk of severe burning at a site other than the site of the electrosurgery. Often, smoke is produced during electrosurgery that can be a risk not only to the patient but also to the surgery team if the room is not effectively ventilated. In 2012, the Association of Surgical Technologists (AST) released their Standards of Practice for Use of Electrosurgery to guide surgeons and healthcare facilities in the safe and proper use of this technology.
Results: Results from electrosurgery can vary greatly depending on the type of procedure performed, the area on which the procedure was performed, and other factors. In general, electrosurgery can be an effective method for removing tumors or for destroying cancerous growths with less blood loss than traditional surgical methods. For some applications, however, there is concern that electrosurgical techniques may lead to a higher rate of recurrence than other available techniques.
Bibliography
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