Surgery, operation, surgical devices, and electrosurgical unit! These names create horrible imagery in our minds, but the truth is, these things are life savior if used in the right direction and under the supervision of expert surgeons. Among these crucial machines or units is; electrosurgical unit, which call electrosurgical cables, or Bovie.
It’s a machine that uses monopolar and bipolar cables (cauterization) during surgery. Before diving deep into the uses, and function of an electrosurgical unit or Bovie machine, let’s take a quick look into its historic significance, from does it comes.
A Little Snippet Into History of Bovie Machine
The Bovie machine started back in the 1920s; there was a physicist named WT Bobe who invented the spark gap generator, which quickly evolved into an electrosurgical generator. After so many upgrades and modifications are done on this machine, now we call it the Electrosurgical Unit.
What an Electro Surgery is – Definition of Electrosurgery
Electrosurgery is an application of an electric current to coagulate tissue at the surgical site. The current flows from the generator to a device or an active electrode that delivers the electric current to the surgical site through the patient or tissue. Then it’s channeled back to the generator using dispersing inactive electrode or grounding pad.
How Electrosurgical Unit Circuit ESU Circuit Works?
When the generator is on, then the active electrode – Bovie is directly plugged in. Usually, it is thrown away in the field to a nurse who plugs it into the Bovie machine, and then the active electrode gets ready to use. One needs to push the button. But it can’t be used if you don’t get the grounding pad hooked up.
The grounding pad itself has a poly adhesive kind of electric goo on it. While applying it to a patient is always used at fleshy parts of a patient’s body such as thighs, buttocks area, the side of the patient, or maybe an upper arm. These are significant fleshy areas of the human body.
Once the grounding pad is all hooked up, you’ll throw off the tail end of electrosurgical cable/cautery, and then you’ll have an active electrode on the field that you can use to cut and coagulate tissue at the surgical site.
As you activate the electrode by using one of the buttons on the Bovie machine, the power source itself will come from the generator down this wire and to a patient’s tissue.
It will go through a tissue of the patient down to the dispersive pad or the ground pad, and it will go through the wire ground pad back to the generator itself.
This is how the circuit of the electrosurgical unit works!
What Is the Use of Mono Polar & Bipolar Cautery?
The ESU circuit, the active electro generator, the active electrode, and the dispersive pad; all are used for monopolar cautery. One single motion of the process going from the generator through the patient’s back and back to the generator.
The bipolar is something entirely different. It’s similar because it does coagulate tissue and cauterize the tissue, but it does that in between the two prongs of actual forceps itself.
Here we learned about electrosurgery and how it is done. Moving to electrosurgical cables, which are also a significant part of an electrosurgical unit.
What is an Electro Surgical Cable?
Electrosurgical cables are known and considered as; wear and tear items during heavy usage. If found a minor crack or break in their insulation, these cables are replaced or replaced immediately upon any observation of cracked insulation or when any corrosion is present.
To unplug the cable from any instrument or equipment, get the fitting coat and don’t pull on the wire. The last will break the joining between the attachment and the link.
All electrosurgical instruments are mainly used for an intended purpose and only use a monopolar or bipolar RF current as specified. These electrosurgical cables, devices, and accessories are only used by expert and qualified physicians who must have strong command over electrosurgeries and operating electrosurgical units.
These electrosurgical instruments and units must be thoroughly examined before each use to ensure they are eligible to use and in proper working order. All removable electrosurgical devices and accessories must be well sterilized before each use.
It’s also imperative to choose a proper technique that can help preserve function and make the instrument long-lasting.
Two Techniques of Using Electrosurgical Cables
Some particular electrosurgical cables are primarily used for cutting tissues. This cutting or dissecting of tissue is usually performed using two different techniques following the situation: bipolar & monopolar.
What is the difference between both techniques?
Mono polar technique: This technique takes a single active electrode that also acts as a neutral electrode. It sends HF current from the generator.
At the point when the anode gets exposed to tissue, a high current thickness is communicated. It is this high gathering of energy on a little zone that achieves the ideal effect.
This current moves through the whole patient’s body to the unbiased anode. This is how the electrical circuit gets shut.
Pros: Best to apply while wilting huge tissue masses
Cons: This strategy isn’t material for patients with pacemakers or metal inserts as it has a higher danger of electric shock
Bipolar method: In the bipolar technique, HF current is displayed through a functioning anode and ways out through an impartial terminal without moving through the patient’s body. This provides an active and neutral electrode to be placed in contrast to each other.
Pros: This technique is safer than the mono polar methodology as there is no threat of devouring or electric stun for the patient; It can be used for patients with pacemakers
Cons: Not suitable for drying huge tissue masses.
Cleaning electrosurgical Instruments & Accessories
It’s a must to commit to basic cleaning instructions for electrosurgical units and instruments. Conventional procedures like ultrasonic cleaning often clean all these devices.
The only exemption for ultrasonic cleaning is hand exchanging (BI-CO-MATIC) bipolar forceps and hand exchanging unipolar handles, which should not be drenched in an ultrasonic cleaner, to ensure their RF-exchanging gadgets.
It should also be noticed that ultrasonic cleaning throughout broadened timeframes can disintegrate the sensitive joints of miniature forceps. Once more, it is significant that electrosurgical embellishments be dry when placed into utilization; irregular execution will be acquired in any case.