Electrosurgery is a widely used technique to cut, coagulate, and control bleeding during surgical operations. The use of electrocautery instruments has revolutionized surgical procedures, making them safer, more efficient and more precise. The two most commonly used types of electrosurgical units (ESU) are bipolar and monopolar.
Bipolar electrosurgical instruments are designed with two electrodes that are closely placed together, allowing the electricity to pass only between them. The current does not flow through the patient's body, and therefore it is safer and produces less tissue damage. Bipolar electrosurgery is commonly used for delicate surgical procedures that require a high level of precision, such as neurosurgery and ophthalmic surgery. Bipolar electrosurgery is also recommended for laparoscopic surgeries as it avoids electrical interference with adjacent structures.
On the other hand, monopolar electrosurgical instruments consist of an active electrode and a return electrode. The active electrode is used to transmit electrical current to the tissue while the return electrode carries the current out of the patient's body through a grounding pad. Monopolar electrosurgery is more versatile than bipolar electrosurgery and can be used for a wider range of surgical procedures, including cutting, coagulation and tissue fusion. Monopolar ESU can also produce a deeper tissue effect, making it suitable for larger surgical operations.
Both bipolar and monopolar ESUs have their own distinct advantages and disadvantages. Bipolar electrosurgery is more precise, safer and causes less damage to surrounding tissues but it is not suitable for all surgical procedures. Monopolar electrosurgery, on the other hand, is more versatile and can be used for a wider range of surgical procedures. However, it requires caution and expertise to avoid unintended burns or electric shock to nearby tissues. Proper patient positioning, electrode placement, and insulation between the electrode and surrounding structures are essential to prevent thermal injuries.
The choice of electrosurgical instrument depends on the surgical procedure and the surgeon's preference. Both bipolar and monopolar ESUs have their own applications, advantages, and limitations. Surgical teams need to be well-trained in the use of electrosurgical instruments and follow the standard guidelines to ensure patient safety and achieve optimal surgical outcomes. With proper training and clinical experience, electrosurgery remains a valuable tool for modern surgical techniques.