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Electrosurgery using insulated needles: basic studies.

We conducted basic studies to evaluate the effectiveness of our insulated needles using raw egg white and fish meat as test material. The basic studies we carried out confirmed that the needles' insulation would withstand the high frequency electric current passed through them. This research served as the foundation for our clinical applications.

Electrosurgery↗

Electrosurgery using insulated needles: treatment of axillary bromhidrosis and hyperhidrosis.

This paper deals with operative techniques and clinical aspects of electrically treating axillary bromhidrosis and hyperhidrosis using insulated needles. Most patients were treated 5 or 6 times using 2 types of needles, one for electroelimination of sweat glands and the other mainly for epilation. The results for most patients were satisfactory, with scarring occurring only in the early developmental stages of the technique.

Adult↗

Electrosurgery principles: cutting current and cutaneous surgery--Part I.

Cutting current is a valuable tool in the office surgical practice due to its speed, efficiency, and economy. Most electrosurgical generators produce a blended wave form that coagulates the tissue as it is cut. Care should be taken to see that the patient is adequately grounded with a dispersive electrode to prevent cutaneous burns. The cutting of the tissue should be brisk and with the smallest electrode and power setting possible. By using careful electrosurgical technique, the surgeon can produce an incised wound that heals as well as one created by cold steel excision.

Anesthesia, Conduction↗

Electrosurgery principles: cutting current and cutaneous surgery--Part II.

The use of cutting current for electrosurgical excision is a valuable procedure for the cutaneous surgeon. Last month, the basic principles of cutting current were reviewed (J Dermatol Surg Oncol 14:29-31, 1988). This month, Part II will cover the technical aspects of cutting current administration.

Dermatologic Surgical Procedures↗

Electrodes for high-frequency electrosurgery.

Among the varied types of electrosurgical electrodes available, many dermatologists find a tapered or needle-shaped electrodesiccation electrode most useful. Cutting current procedures are best accomplished with fine needle or wire electrodes. Both monopolar and bipolar forceps are useful for pinpoint coagulation of small blood vessels. Because of increasing concerns about electrode contamination, several kinds of disposable electrodes are now available.

Dermatologic Surgical Procedures↗

Modifications of electrosurgery electrodes.

Dermatologists often find that electrosurgical electrodes that are commercially available do not always suit their specific clinical requirements. Some physicians modify electrodes to achieve specific electrosurgical effects. The more popular modifications have given rise to new varieties of commercially available electrodes.

Dermatology↗

Thermal injury by in vitro incision of equine skin with electrosurgery, radiosurgery, and a carbon dioxide laser.

Freshly harvested equine skin incised with an electrosurgical unit, a radiosurgical device, or a carbon dioxide (CO2) laser was examined by light microscopy to determine the extent of thermal injury caused by each instrument. There was no significant difference between the thermal injury caused by the electrosurgical unit in the pure-cut mode and the CO2 laser in the superpulse mode, or between the electrosurgical unit and the radiosurgical device in the fully filtered cut mode. However, thermal injury caused by the CO2 laser was significantly less than that caused by the radiosurgical device. The amount of thermal injury in this in vitro study was similar to that found in vivo with other species.

Analysis of Variance↗

Systematic review of the safety of electrosurgery for tonsillectomy.

In the meta-analysis models, compared with cold steel dissection with ties/packs haemostasis (reference technique): * Bipolar diathermy dissection and haemostasis was associated with statistically significant lower odds of primary haemorrhage (OR 0.13, 95% CrI 0.03 to 0.51), including primary haemorrhage requiring return to theatre (OR 0.002, 95% CrI <0.001 to 0.26). * Coblation was associated with statistically significant higher odds of secondary haemorrhage requiring return to theatre (OR 33.82, 95% CrI 1.25 to 5676.00). * Monopolar and bipolar diathermy dissection and haemostasis (OR 4.12, 95% CrI 1.12 to 14.67; OR 2.86, 95% CrI 1.12 to 8.02, respectively), coblation (OR 3.75, 95% CrI 1.29 to 12.12), and cold steel dissection with monopolar or bipolar diathermy haemostasis (OR 4.83, 95% CrI 1.56 to 15.95; OR 9.18, 95% CrI 3.09 to 30.53, respectively) were all associated with statistically significant higher odds of secondary haemorrhage. * In deciding which technique to employ, factors to consider include patient characteristics, the underlying risk of primary or secondary haemorrhage, which is regarded as likely to be more serious, and the clinical significance of the observed differences in haemorrhage rates across techniques.

Electrocoagulation↗

Electrosurgery: VaporTrode.

Despite subjective and objective success rates approaching 90%, significant morbidity is well documented using a wire loop for standard transurethral resection of the prostate (TURP). In an effort to minimize patient morbidity as well as limit future healthcare costs, several alternative instrumental techniques have been examined. Recent studies of transurethral electrovaporization of the prostate, a modification of existing transurethral technology, appear encouraging. The modifications which enable larger volumes of tissue to be vaporized with concurrent desiccation and coagulation are an increase in the surface area of the electrode and effective delivery of high electrical energy by electrical generators. The most extensively studied instrument is the VaporTrode. Promising early published reports of TURP-like efficacy without significant morbidity, as well as low cost, have fueled the popularity and wide application of this technique.

Electrosurgery↗