Nowadays, surgery using high-frequency electrosurgical devices is one of the modern technologies, without the use of which surgical interventions in large numbers are simply not possible. These are primarily areas of medicine such as neurosurgery, gynecology, oncology, gastroenterology and other areas of general surgery.

High frequency electrosurgery (HFES) today refers to the method of applying high frequency current to biological tissues for electrotomy and coagulation. This technique is based on the effects of high temperatures produced by the passage of high-frequency current through the human body.

During the local heating of the tissue with a special high-frequency current, the tissue is coagulated. At the same moment, protein denaturation takes place – protein tissues are coagulated, so that small vessels are coagulated, providing hemostasis. Coagulation is not only used for hemostasis. This method is also used when it is necessary to mechanically connect different tissue fragments (“weld” together vessels, alveoli, which detached from the tissue during pathological processes), to remove different tumor formations, to treat varicose veins and other diseases.

To cut the patient’s tissues, heat is used, which is released when a current of increased density is applied to them, compared to the one used in coagulation. Local application of the current allows for the release of heat, under the influence of which fluids instantly boil, resulting in the rupture of tissue near the surface of the cutting electrode. At the same time this very heat provokes coagulation of protein in the tissue and simultaneous coagulation of the tissue as it is dissected.

How electrosurgical units work
There are two ways in which electrosurgical devices work: monopolar and bipolar. In the monopolar technique, current flows through the human body and passes to the passive electrode from the active electrode. The active electrode has a fairly small working area, which is why the current of maximum density is concentrated near the electrode, which provides tissue heating. Exposure of monopolar type is used both for cutting the body tissues and for their coagulation. In some cases, the passive electrode is not used when using the monopolar method. In this case the person is placed on the ground and the second generator output is grounded, the high-frequency current passes directly through the patient’s body and is shorted to the generator.

With the bipolar method, the two generator outputs are connected to active electrodes that are combined into a single structure, a single surgical instrument. For example, this might be a bipolar coagulation forceps. When such a surgical electric tool is exposed, the distance between the two active electrodes is equal to a value on the order of the linear size of their working areas. For this reason, the current distribution takes place in the area between the electrode surfaces and the volume of the affected tissue is rather small.

Electrosurgery has a lot of advantages but also some disadvantages. If physicians do not fully follow the rules for operating electrosurgical equipment, the patient can be struck by the high frequency current. These rules include guidelines for the use of the electrosurgical unit itself, as well as for the use of the ECHF unit simultaneously with other equipment.

Today, modern medicine uses a solid number of ECHF devices, which differ from each other in their size and parameters, design features, provided modes and set of tools.

Usually, general surgery uses universal electrosurgical devices, which have a large number of different modes and a set of working tools, as well as high power output, which allows the use of these devices in various surgical interventions.