Tips y fundamentos para el uso de la unidad electroquirúrgica en endoscopia / Recommendations and rationale for the use of electrosurgical unit in endoscopy

Electrosurgical unit (ESU) is a critical piece of equipment in any endoscopy rooms because is used in the ma- jority of endoscopic therapeutic procedures. However, many endoscopists are not well-trained on their use and their physical bases are usually not properly studied or understood. A good understanding of the principles of electrosurgery and various configurations available in the ESU is essential for the effective and safe use during endoscopy. The aims of these article are to: (1) expose physical principles relevant to the understanding of elec- trosurgery during endoscopy; (2) describe and provide practical recommendations regarding two ESU that are commonly in use; (3) review usually factors relevant to commonly performed therapeutic procedures, including polypectomy, sphincterotomy, contact thermal hemostasis, argon plasma coagulation, etc. (4) discuss the clinical relevance of technologies recently implemented in newer electrosurgical units and future perspectives with the artificial intelligence.

La unidad electroquirúrgica (UEQ) es un equipo fundamental en cualquier sala de endoscopia, ya que se utiliza en la mayoría de los procedimientos terapéuticos. Sin embargo, muchos endoscopistas no están del todo capacitados en su uso y sus bases físicas no suelen estudiarse ni comprenderse adecuadamente. Un buen conocimiento de los principios electroquirúrgicos y de las diversas configuraciones disponibles en la UEQ es esencial para un uso eficaz y seguro durante la endoscopia. Los objetivos de este artículo son: (1) Exponer los principios físicos relevantes de la electrocirugía durante la endoscopia; (2) Describir y proporcionar recomendaciones prácticas con respecto a las dos UEQ más comúnmente utilizadas; (3) Revisar los factores generalmente relevantes para los procedimientos terapéuticos que se realizan con frecuencia, incluida la polipectomía, la esfinterotomía, la hemostasia térmica de contacto, la coagulación con argón plasma, etc. (4) Analizar la relevancia clínica de las tecnologías implementadas recientemente en las UEQ más nuevas y las perspectivas futuras con el advenimiento de la inteligencia artificial.

Quality control method and detection data analysis of electrosurgical unit / 中国医学装备

Objective:To establish the quality control method of electrosurgical unit(ESU) through the safety performance test and data analysis for electrotome.Methods: According to the testing standard of ESU, Fluke ESA612 electrical safety analyzer and QA-ES II electrosurgery unit analyzer were applied to test the properties of ESU were using during 2015 and 2016, and the testing results were analyzed.Results:In 2015 and 2016, the qualified rate of quality control results were 79% and 81%, respectively; the problems of unqualified ESU were resolved and their hidden risks in clinical applications were eliminated.Conclusion: By testing the properties of ESU, we can master the performance of the machine; find and deal with the risk of machine in time, and avoid the hidden danger and enhance the risk management for ESU, so that the machine can be safely and effectively applied in clinical surgery.

Research on high frequency electrotome quality detection method / 中国医学装备

Objective:To analyze the high frequency electric knife detection methods, effective detection methods is used to solve problems in testing, the high frequency electricity knife quality is ensured finally.Methods: According to the national calibration specifications, the high frequency electricity knife analyzer is used to test, the problems are found, the experience is sum up.Results:By using the method of testing for a long time, the hidden danger is eliminated of the high frequency electrical knife, the accuracy of the high frequency electric knife is ensured, so that it is more safe and reliable in clinical.Conclusion: The quality control of high frequency electric knife test is an important part of medical safety, the value of high frequency electric knife is ensured through the tested periodically, so it can better service to patients.

Long-Term Evaluation of Tumor Removal at the Eyelid Margin Using a Radio-Frequency Electrosurgical Unit

PURPOSE: To evaluate the long-term follow-up results of the eyelid margin tumor resection using a radio-frequency electrosurgical unit. METHODS: We retrospectively reviewed the medical records of 53 patients (55 eyes) diagnosed with eyelid margin tumor and who underwent eyelid tumor resection using a radio-frequency electrosurgical unit more than 5 years prior. Age, gender, undergoing a biopsy, recurrence,- and complications were examined through phone questions and the out-patient department. RESULTS: The study included 23 eyes of 22 males and, 32 eyes of 31 females, (age range 8.6-76.8 years). Surgical success rate was 95% (52 of 55 eyes) and mean follow-up period was 8.9 years. Thirty-four of 55 patients underwent a biopsy, and the most common cases were intradermal nevus and compound nevus (13 cases each), 2 cases of basal cell carcinoma (5.9%), 2 cases of actinic keratosis (5.9%), and, 2 cases of chronic inflammation (5.9%). Other cases included 1 case of squamous papilloma (2.9%) and 1 case of fibrosis (2.9%). There were 3 cases of recurrence. Eyelash-related complications after surgery occurred in 3 cases of trichiasis or distichiasis. CONCLUSIONS: Eyelid margin tumor resection using a radio-frequency electrosurgical unit is simple and showed high success rate. Additionally, it is considered as an effective method in the eyelid margin tumor resection due to low recurrence and complication rates in the long-term follow-up.

The Effect of Conjunctivochalasis Surgery Using a High-Frequency Radio-Wave Electrosurgical Unit

PURPOSE: To evaluate the effects of conjunctivochalasis surgery using a high-frequency radio-wave electrosurgical unit. METHODS: Twenty-seven eyes of 14 patients with conjuctivochalasis who received surgeries with shrinkage of the inferior bulbar conjunctiva using a high-frequency radio-wave electrosurgical unit (Ellman surgitron(R)) were evaluated. Conjuctivochalasis grade, the ocular symptoms, Ocular Surface Disease Index (OSDI), tear film break-up time (BUT), Schirmer test, and corneal staining with fluorescein were measured preoperatively, at 3 months postoperatively, and analyzed prospectively. RESULTS: Three months after the surgery, all patients' conjunctivochalasis became grade 0, and the ocular symptoms, OSDI score, BUT, and corneal staining with fluorerscein were also improved. Additionally, there were no specific complications during the follow-up period. CONCLUSIONS: Conjunctivochalasis surgery using a high-frequency radio-wave electrosurgical unit produced an effective improvement in conjuctivochalasis grade and symptoms and appeared to be a simple and safe procedure.

Fires and Burn Caused by Alcohol-based Disinfectants and Electrocautery: A case report / 대한마취과학회지

Operating room fires, though rare, can involve substantial morbidity and mortality. Surgical fires require an ignition source, oxidizer, and fuel. Ignition sources generally include lasers and electrocautery, oxidizer are usually oxygen, nitrous oxide, and ambient air, whereas fuels are classically surgical drapes, materials, and prepping agents. We experienced a patient who, during skin incision, sustained burns resulting from a fire in the operating room. Shortly after application of disinfectants and placement of the surgical drapes, the surgeon used the electrosurgical unit on the incision. In this case, the use of an alcohol-based disinfectant was the major contributing factor to the surgical fire. To avoid recurrence, if alcohol is used for skin prepping, it should be allowed to dry completely before draping.

Endoscopic thyroidectomy without the use of ultrasonic scalpel: Report of 6 cases / 中国微创外科杂志

Objective To explore the feasibility of endoscopic thyroidectomy without the use of ultrasonic scalpel.Methods Monopolar high frequency electrosurgical unit was used to complete endoscopic thyroidectomy in 6 cases of thyroid benign tumors.Results All the operations were completed successfully.The operation time was 80~200 min(mean,110 min) and the intraoperative blood loss was 25~50 ml(mean,36 ml).The patients got out-of-bed activities and took liquid diets at a mean of 24 hours postoperatively.No complications was found.The drainage tube was removed on 2 days after operation and the patients were discharged from hospital at 3~5 days.Conclusions Use of high frequency electrosurgical unit for endoscopic thyroidectomy is safe and feasible.

Electric and laser energy for endoscopic surg

Improvements in surgery have focused on refinements in the ability to dissect and limit blood loss. The electrosurgery unit (ESU) and laser (light amplification by stimulated emission of radiation) have been widely used in recent endoscopic surgery. ESU is a form of surgery in which high-frequency (100 kHz-5 MHz) electric currents are used to incise, destroy, and remove tissue and to seal blood vessels in order to maintain hemostasis. The use of lasers in surgery has added a new dimension to operative technique through increased precision, improved hemostasis, and less tissue manipulation. This paper aims to explain the basic principles and applications of electrosurgery and lasers.

Electrosurgical Burn at the Site of EKG Electrode: A case report / 대한마취과학회지

In the operation room, members of the surgical team have the ultimate responsibility of safe guarding the patient from electrical devices. The electrosurgical unit is one instrument commonly used during surgical procedures. We have experienced accidental burning. Sixty-seven years-old patient received burn at the site of the ECG electrode which was caused by an electrocautery used in conjunction with electronic monitoring equipment. Although cutting and coagulation powers were very low, the normal size of the ECG electrodes led to the generation of a high current density. Prevention of interactions of this kind between properly functioning monitoring and surgical units requires good communication among all members of the operating room team and every electrical instruments should inspected, tested regularly.

A Case Report of Electrical Burn by Ground Plate of Electrosurgical Unit / 대한마취과학회지

A electrical safety in the operating room is one of important responsibility for the anesthesiologists and surgeons. When the patient is included in an electric circuit with poor ground during operation under the general anesthesia electrical accident might be occurred, such as sustained muscular contration with asphixia, impairment of CNS function, ventricular fibrillation, and more commonly, burn and other physiological injuries. Authors report an electrical burn on the right calf area (3X5 cm) and both heels by ground plate of electrosurgical unit which is probably poor contacts with the patient and review about its prevention and safety of electric practice.