What is Electrosurgery?

Lisa Simonelli Rennie

The term electrosurgery refers to the use of a high frequency electrical current to to cut, dissect, or coagulate tissue. This alternating current applies direct heat to the tissue, while keeping the tip of the probe relatively cool. The procedure is performed using an electrosurgical generator and a hand piece that includes an electrode, which is sometimes referred to as an RF knife. The main benefit of electrosurgery is to limit as much blood loss as possible when cutting damaged tissue, and to make exact, precise cuts during surgery.

Electrosurgery can be used to treat certain ocular disorders.
Electrosurgery can be used to treat certain ocular disorders.

Although electrosurgery is used in orthopedic, dermatological, cardiac, gynecological, plastic, ocular, and urological surgical procedures, it is most commonly used to remove or destroy cancerous cells. The procedure is used to treat skin and oral cancers at the outermost layer, as well as basal and squamous cell carcinoma. To remove the cancerous cells, electrosurgery can be used in conjunction with radiotherapy or chemotherapy.

Electrosurgery may be used in conjunction with radiotherapy to treat cancer.
Electrosurgery may be used in conjunction with radiotherapy to treat cancer.

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Basal cell cancer usually appears on sun-exposed areas of the body, such as the head, face, chest, and back. Squamous cell cancer is also associated with these sun-exposed areas, but it usually affects only the top layer of skin while leaving other healthy tissues alone. Electrosurgery has an approximate success rate of 99% when removing basal cell cancer that is less than 1 cm (0.4 inch) wide and an 84% success rate when removing a cancerous mole that is 2 cm (0.8 inch) wide.

Electrosurgical devies were developed at Harvard University.
Electrosurgical devies were developed at Harvard University.

Many times electrosurgery is used in conjunction with a cutterage procedure, which involves cutting away damaged or cancerous tissue with a spoon-shaped device. After a cutterage procedure has been done, electrosurgery can follow to burn the skin tissue to help control bleeding, and to kill any cancerous cells that remain. This procedure is sometimes preferred over laser surgery.

Cancerous skin cells may be removed with electrosurgery.
Cancerous skin cells may be removed with electrosurgery.

The first electrosurgery was performed in 1926 by Dr. Harvey Cushing. The actual electrosurgical device was invented by Dr. William T. Bovie, who developed it from 1914 to 1927 at Harvard University. As such, many electrosurgeons today still refer to the device as a "Bovie" when used for coagulation in surgery.

Electrosurgery is often confused with a procedure called diathermy, which also involves the usage of heat. The heat involved with diathermy is produced by the rotation of polar molecules in a high frequency-alternating electric field, however. This is also the type of heat used in many microwave ovens.

In some cases, electrosurgery is preferred over laser-based treatments due to its increased effectiveness.
In some cases, electrosurgery is preferred over laser-based treatments due to its increased effectiveness.

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