AMT ELECTROSURGERYINTEGRATING SAFETY AND PERFORMANCE

BASICS OF ELECTROSURGERY

Basics of Electricity

Electrosurgial Principles

• Current follows pathway of least resistance

• Current always seeks to complete the circuit

• As Resistance within the circuit increases, current flow decreases

Neromuscular Stimulation

Tissue Effects:

• Cutting

• Desiccation

• Fulguration

• Soft Coagulation

• Bipolar

• Argon Plasma Coagulation

Cutting

• Continuous high-frequency current– Cause quick, clean cutting – Minimal Thermal Artifact

• Blended Current− Combination of cutting and coagulation

waveform characteristics − Moderate hemostasis

Desiccation (Forced Coag)

• Contact Coagulation– Slow drying out of tissue– Varying degrees of thermal artifact– Causes eschar to form

Fulguration (Spray Coag)

• Non contact

• High Voltage

• Electrical current arcs from electrode to tissue

• Superficial

Soft Coagulation

• Contact Coagulation

• Low Voltage

• Continuous waveform

• Non Sticking non charring

• Reproducible

Bipolar

• Contact coagulation

• Low voltage

• Safer than monopolar

• Non charring

Argon Plasma Coagulation

• Non contact

• Non Charring

• Superficial

Argon Plasma Coagulation

Argon Plasma Coagulation

ESU’s

• Conventional

• Constant Voltage

• Hyfrecator

• Argon Plasma Coagulation

Return Electrodes

• Non CQMS

• CQMS

• Capacitive Pads

CQMS Technology

Capacitive Pad

Active Electrodes:

• Monopolar– Pencils– Laparoscopic– Forceps

• Bipolar– Laparoscopic– Forceps

Troubleshooting

• Operator Errors

• System Errors

• Accessory Failures

Buzzing a Hemostat

• Good Practice?

• How to do it safely

Surgical Staff Burns

• How do they occur?

• How to avoid them