What Is Electrosurgery?
Electrosurgery is commonly used in urologic and dermatologic surgeries to remove skin tissues. Skin is an important organ of the body that acts as the first line of defense against various microorganisms. However, the skin is a bad conductor of electric current, and this property is used in electrosurgery to cut the deeper tissues of the skin. The electrical energy builds up in the skin, and the heat produced due to this energy removes the excess tissues. The tissues are removed by the following three mechanisms:
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Dehydration - Dehydration is a procedure in which water is removed from the aqueous tissues. Normally, the tissues contain some amount of water around them. Electrosurgery removes this water so that the tissues become weak and can be removed easily.
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Coagulation - Coagulation is a procedure in which a blood clot is formed to stop bleeding. Tissue coagulation is a part of electrosurgery.
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Vaporization - Tissue vaporization is linked to dehydration. When the electric energy gets converted to heat, vaporization of the interstitial fluids occurs.
What Are the Different Types of Electrosurgery?
Electrosurgery is classified into different types based on clinical applications. The different types of electrosurgeries are described in the table below:
What Are the Uses of Electrosurgery?
As the name suggests, electrosurgery is a procedure that uses electric current to desiccate the tissues. Electrosurgery is commonly used in dermatology to treat the following conditions:
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Acne of the neck and scalp.
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Acrochordon (skin tags).
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Angioma (mass formed by the blood vessels).
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Verrucae (small lumps that form on the skin surface and subside on their own after some time).
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Mucous cysts (fluid-filled swelling that occurs on the mouth).
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Nevi (mole or birthmark).
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Seborrheic keratoses (tumors of the eyelids and cheek).
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Precancerous lesions like actinic keratoses.
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Squamous cell carcinoma (a severe type of skin cancer).
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Superficial basal cell carcinoma (a type of skin cancer that occurs on the areas of the skin exposed to the sun).
What Is Urology?
Urology is a branch of medicine that deals with studying conditions affecting the male and female urogenital tract. Urology addresses urinary tract problems and the reproductive organs like the testes, ovaries, penis, scrotum, and prostate. Doctors who specialize in the field of urology are known as urologists. They are trained to diagnose, detect, and treat conditions affecting the kidneys, bladder, ureters, and urethra. In males, a urologist might also resolve problems with the testis, scrotum, and penis. In contrast, the urologist addresses the problems of the vagina, cervix, and other reproductive organs of females. Sometimes, the urologist might need to work with a radiotherapist and an oncologist to treat urinary cancer.
What Is a Urinary Tract?
The human body comprises nine major organ systems that work as a team to carry out the body's essential functions and keep it healthy. The urinary system is one of them and consists of several organs that work to remove waste from the body. In addition to the urinary system, other organs within the body helps get rid of waste. The urinary tract organs are connected with the help of tubes and are further connected to the digestive system and the blood vessels. The body derives energy from food to carry out daily activities. After the body has used the food products, unused ones are left as waste in the blood and the bowel. The urinary system filters blood, and the waste products are separated and converted to urine.
What Procedures Are Involved in Electrosurgery?
As the name suggests, electrosurgery is a procedure wherein the site is operated using an electric current. The following procedures form an integral part of electrosurgery:
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Cutting - The electrodes attached to the electrosurgery equipment generate sparks. As a result, the electrical energy gives rise to a temperature of 100 degrees, causing the rupture of the tissue membranes. When the liquid inside the tissues vaporizes, they become weak and detached from the skin.
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Coagulation - Coagulation current generated by electrosurgery is used to staunch bleeding. When the electrode touches the skin surface, the liquid vaporizes, and the tissues dry out and shrink.
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Devitalization - Electrosurgery is used to devitalize the tissues because it generates 50 to 60 degrees or above temperatures. Electrosurgery is used to devitalize the tissues because it generates 50 to 60 degrees or above temperatures. As a result, the tissues get irreversibly damaged.
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Vessel Sealing - Vessel sealing is done to close the blood vessels and tissue bundles. The tissue can then be removed manually.
What Are the Different Techniques of Electrosurgery?
Electrosurgery can be done through different techniques in urology. The different techniques of electrosurgery are listed below:
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Monopolar Technique - In monopolar electrosurgery, current flows from the source to the instrument and then to the patient’s body. Finally, the current flows from the patient’s body to the unit. When the tip of the electrode comes in contact with the patient’s body, a high-intensity current is generated that allows the doctor to make an incision.
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Bipolar Technique - The bipolar technique is similar to the monopolar technique, except that the current flows in a controlled amount. Instead of directly flowing through the patient’s body, the current flows only into the target tissue. As a result, sensitive structures like nerves and blood vessels are saved from getting damaged.
How Is Electrosurgery Useful in Urology?
Several urologic procedures can be done by electrosurgery. A skin incision can be made with the help of a needle electrode. Electrodes separate the muscle layers to locate the target tissues. The surgical procedures that can be done by electrosurgery are listed below:
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Partial Nephrectomy - It is a procedure in which a part of the kidney is removed to treat a tumor, infection, or other diseases. First, the doctor makes an incision with the electrode tip to expose the kidney capsule. The advantage of electrosurgery is that the depth up to which the tissue is to be removed is already set on the equipment. Hence, the doctor can regulate the depth of insertion of the instrument. Blood loss, ischemia, and the time of surgery are reduced, and the healthy kidney tissues remain protected.
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Pyeloplasty - Pyeloplasty is a procedure in which the ureters are repaired surgically. The doctor makes an incision and exposes the ureters with the help of electrosurgery. The risk of thermal necrosis, perforation, and ureteral stenosis is minimal with electrosurgery.
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Adrenalectomy - Adrenal glands are located above each kidney. They regulate the endocrine functions of the human body. Adrenalectomy is a procedure in which the adrenal glands are removed to treat tumors, cysts, and abscesses. Electrosurgery helps to expose the adrenal gland and treat its problems without damaging the surrounding structures.
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Radical Prostatectomy - It is a procedure in which the prostate gland is removed surgically to treat prostate carcinoma. The skin near the prostate gland can be incised using electrosurgery, and the muscle layers are removed by a knife electrode to expose the gland.
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Cystectomy - Cystectomy is a procedure in which the urinary bladder is removed surgically to address the problems like bladder cancer, neurogenic or overactive bladder. After the bladder has been removed surgically, the intestinal portion can be connected to the ureters with the help of electrosurgery.
Conclusion:
Electrosurgery is commonly used in urology to treat a variety of problems. An electrosurgery machine consists of electrodes that generate a high-intensity electric current to cut the tissues. Earlier, doctors used to perform only laparoscopic and open surgery to address urinary tract problems. However, the advancement in medical science and the invention of electrosurgery has paved the way for the atraumatic surgical experience.
The biggest advantage of electrosurgery is that it is less time-consuming, and the patient need not stay in the hospital for long. However, the surgery must be carried out in the expert’s hands because the electrodes emit a large amperage of current that might damage the healthy tissues. Consult a urologist to learn more about electrosurgery and its advantages.
