Electrosurgery Unit Research Articles

Design and Testing of Electrosurgery Unit

Bleeding during surgery is common in major surgical operations. So, it is not recommended to make an incision using a conventional scalpel. As an alternative to replacing a conventional scalpel, an electric scalpel or know as electrosurgery unit (ESU) is made by utilizing a high frequency whose duty cycle can be adjusted and then being focused on one point is a solution to prevent bleeding. This research will design a bipolar electric scalpel or bipolar electrosurgical unit with a frequency of 210-250 KHz and an input voltage of 50-90 VDC to perform pure cuts on chicken meat samples. The box pulse frequency will be generated from IC 4069. The output of the oscillator generator will read the high and low voltage on the Arduino Nano digital pin. The current will be amplified at the oscillator output and then processed in the inverter driver circuit. The selection of the DC input voltage will use a voltage driver circuit. The inverter driver output and voltage driver will be step-up to get a maximum power of 10.4W with a resistance of 100Ω at a frequency setting of 210 KHz and an input voltage of 90 VDC and a minimum power of 1.4W with a resistance of 100Ω at a frequency setting of 250 KHz and input voltage 50 VDC.

A Low Cost Electrosurgery Unit (ESU) Design with Monopolar and Bipolar Methods

Surgery using a conventional scalpel causes the patient to lose a lot of blood; this needs to be avoided. The purpose of this research is to make a replacement for the conventional scalpel using a device that utilizes high frequency with a duty cycle setting that is centered at one point. The design of the device is equipped with monopolar and bipolar pulse selection with an increased frequency at 400 kHz, where the duty cycle of bipolar mode can be set to 100% on and the coagulation duty cycle is 6% on and 94% off. The power output of the module was tested using an ESU Analyzer, while cutting the bipolar forceps used soap and meat media. The power inverter circuit was set with the module impedance values ​​of 300Ω, 400Ω, and 500Ω. Power settings were set at high, medium, and low with 2 pulse cutting and coagulation modes. The average power resulted in the lowest power of 32.3Watt and the highest power cutting mode of 58.3Watt. Meanwhile, in the coagulation mode of the lowest power of 3Watt and the highest power of 3Watt, the impedance setting is 500Ω. The module can output power linearly according to settings and can cut media well. Furthermore, the development of making Electrosurgery design in this study is expected to facilitate the surgical process during the surgical procedures.

A Modified Electrosurgery Unit Based on High Frequency Design with Monopolar and Bipolar Method

Electrosurgery Unit is some machine to human body surgery. Electrosurgery Unit is uses a high frequency to human body tissue surgery, that causes blood who came out can be dicrease during surgery. When using a conventional scalpel is something that is highly avoided because it will cause contraindications to lack of blood which will be very dangerous for the patient. The purpose of this study is to design a tool that is used to replace a conventional scalpel with a tool that utilizes high frequency (400 KHz) generated by the oscillator circuit. In this study. The researches used Monopolar method and used two modes Cutting and Coagulation in order to eliminate faradic effects on body tissues causes high frequency, there is the high frequency will be adjusted to the duty cycle which aims to obtain various types of surgery required by doctor which is cutting 100% on and coagulation 6% on 94% off where is set it with arduino program. In this study, the researchers took advantage of the type of heat effect produced by high frequencies which were concentrated at one point so that it could be used to carry out the process of surgery on body tissues so as to minimize the occurrence of large blood loss. The result of this study is will be centered at one point on an object there is show up the depth difference of the cutting mode and the wide large difference of the coagulation mode. The module design resulted the power lowest at 300Ohm ESU Analyzer setting is 30Watt and the highest at 300Ohm setting too is 68Watt. The module design resulted the power lowest at 300Ohm ESU Analyzer setting is 30Watt and the highest at 300Ohm setting too is 68Watt at mode Cutting and the highest and lowest Coagulation mode using impedance setting the same there is 300 Ohm is constant 3Watt power result’s. The weaknesses at this research is the power still lower then the Electrosurgery Unit where is in the hospital. It can be fix for the next research using increase the final amplifier and maybe increase the frequency where is gonna make the voltage of the final amplifier be much better then this research

Cutting Monopolar Needle Electrode of Electrosurgery, a Safe Tool for Skin Incision in Neurosurgery

In ancient time heat was used to treat wounds. Now a days electrosurgery unit (ESU) is an important part of operation theatre equipments utilized by almost every surgeon. Electrocautery and diathermy are the term used by many operations theatre medical and paramedical persons including surgeons for electrosurgery. They altogether are three different things. Cutting monopolar needle electrode of electrosurgery is a safe tool for skin incision in neurosurgery but hardly very few surgeons are utilizing it as a tool for making skin incision. Reason for not using it probably is the fear of poor wound healing and deep burn of underline tissue or awareness about it. The objective of this case study is to bring awareness about 'cutting monopolar needle electrode of electrosurgery' as an available tool for skin incision in neurosurgery with less blood loss and marked reduction in incision time than stainless steel surgical blade.

A Coagulation Mode on Bipolar Electrosurgery Unit Using 350 KHz Frequency and Power Selection

Losing a lot of blood during surgery using a conventional scalpel is something that is highly avoided. The purpose of this study is to replace the conventional scalpel with a tool that utilizes a high frequency whose duty cycle is regulated and then centered at one point. Researchers take advantage of the effect of heat generated by high frequencies which are centered at one point so that it can be used for the process of surgery and coagulation in body tissues so as to minimize the occurrence of a lot of blood loss. Researchers use a high frequency of 350 KHz which is set with a duty cycle of 6% on 94% off and is equipped with 3 levels of power selection and uses forceps as a medium to concentrate high frequencies at one point. The module design consists of a 350 KHz frequency generator, a pulse control circuit to adjust the duty cycle, a power control circuit as a power setting, a driver circuit to combine the frequency with the set power so that different outputs are obtained according to the settings, and an inverter circuit to increase the voltage. In this study, after measuring using an oscilloscope in the driver circuit, the average output amplitude at each low, medium, and high setting was 27.25 Vpp, 28 Vpp, and 28.625 Vpp. The results showed that the bipolar electrosurgery unit (coagulation) module as a whole can replace conventional scalpels so that it can minimize the occurrence of a lot of blood loss during surgery. However, the frequency generator and power selection need to be improved.

Education and gastroenterology fellow knowledge about endoscopic mucosal resection of colon adenomas: a survey-based study.

Background and study aims Endoscopic mucosal resection (EMR) is an effective way to remove large (> 2 cm) colon adenomas. Training about it has not been standardized in fellowship programs. This study was aimed at evaluating the education and knowledge of gastroenterology fellows about EMR of colorectal adenomas. Methods Participation in this survey was offered to 1730 gastroenterology fellows in the United States during the academic year 2019 to 2020. The survey assessed endoscopic mucosal resection training and knowledge and was approved and administered by the American College of Gastroenterology. Results A total of 163 fellows (9.4 %) completed the survey. Only 85 fellows (52.1 %) reported receiving formal education in endoscopic mucosal resection. Fellow confidence was lowest regarding knowing electrosurgery unit settings. Fewer fellows correctly identified Paris 0-IIb (79, 48.5 %; P < 0.0001) or NICE I (114, 69.9 %; P < 0.01) lesions as compared to other Paris and NICE III lesions, respectively. Only 73 (44.8 %) and 93 fellows (57.1 %) arranged steps of EMR in the correct order and identified the correct type of current used for resection, respectively. Training year, male sex, and provision of advanced endoscopy rotations during fellowship were associated with a higher knowledge score for EMR. Conclusions Nearly half of all fellows reported no formal education in EMR and incorrectly ordered its steps. Adenoma assessment by Paris and NICE classifications and electrosurgery unit settings were the most prominent knowledge deficiencies. Incorporation of standardized training about EMR with inclusion of advanced endoscopy rotations appears to be an important educational opportunity during gastroenterology fellowship.

Utilization of Power Setting in Monopolar Electrosurgery Unit With Additional Blend Modes

Electrosurgery unit has the purpose of damaging certain body tissues by heating the tissue. In this study there are several modes and also power selection. The contribution of this research is to design the power management and also the addition of several modes for the surgical process. Electrosurgery Unit involves the use of IC CMOS 4069 as a frequency generator. The frequency output is set at 250 KHz and then passed on to the pulse regulator circuit and controlled by using Arduino and then forwarded to the inverter circuit which functions to increase the voltage and output in the form of power. Modules are calibrated using ESU Analyzer. This module is equipped with a selection of LOW, MEDIUM, and HIGH power. And also there are some additional modes including Blend 1 and Blend 2. After the measurement is carried out, the voltage values ​​obtained at the setting of low, medium high, on the inverter input with a value on Blend 1 mode low 80 V with an error of 0.84%, Medium 90 V with error 0.84%, High 104 V with an error of 0.81%, in Blend 2 mode low 84 V with an error of 0.83%, Medium 86 V with a error of 0.85%, High 105 V with an error of 0.81%, the Cutting mode is low 162 V with an error of 2.88%, medium 172 V with an error of 3.03%, High 192 V with an error of 2.86%. The measurement shows an error of less than 1% for Blend 1 and Blend 2 modes while cutting is less than 3%. The results of this study can be implemented in order to minimize errors due to lack of power settings and mode selection during surgery.

An Improved Power Management System in Electrosurgery Unit Monopolar Design

In using the Electrosurgery unit, improper power settings and modes can cause tissue damage, so it is necessary to adjust the cutting mode and power settings needed. The purpose of this research is to design power control and cutting mode in Electrosurgery using Arduino nano as a regulator of power and pulse or duty cycle. The contribution of this research is the creation of power control and mode in the Electrosurgery unit to increase power and cutting mode. This is to control the electrosurgery power. The LM2907 IC frequency to voltage circuit is used as a voltage regulator, which is issued according to the frequency with the power selection LOW, MEDIUM, HIGH. The method used is the CMOS 4069 device as a frequency generator at 250 kHz, then the driver pulse is passed and controlled by the ATmega328 IC, then forwarded to an inverter circuit that functions to increase the voltage and output in the form of power. After the measurement process is carried out on the inverter input with a Blend mode three value, the voltage value is obtained at the low setting 100 V error 0.03%, medium setting 110V error 0.02%, High setting 120 V Error -0.02%. While the measurement results in the coagulation mode are the low setting error of 100 V 0.05%, the medium setting error is 110V 0.08%. High setting error is 130 V 0.003%. The measurements show that the error in power management is lower than 1%. The results of this study can be implemented in the electrosurgery unit to reduce tissue damage due to a lack of cutting modes and power management.

Utilization of Power Setting in Mono-polar Electrosurgery Unit With Additional Blend Modes

Electrosurgery unit has the purpose of damaging certain body tissues by heating the tissue. In this study there are several modes and also power selection. The contribution of this research is to design the power management and also the addition of several modes for the surgical process. Electrosurgery Unit involves the use of IC CMOS 4069 as a frequency generator. The frequency output is set at 250 KHz and then passed on to the pulse regulator circuit and controlled by using Arduino and then forwarded to the inverter circuit which functions to increase the voltage and output in the form of power. Modules are calibrated using ESU Analyzer. This module is equipped with a selection of LOW, MEDIUM, and HIGH power. And also there are some additional modes including Blend 1 and Blend 2. After the measurement is carried out, the voltage values ​​obtained at the setting of low, medium high, on the inverter input with a value on Blend 1 mode low 80 V with an error of 0.84%, Medium 90 V with error 0.84%, High 104 V with an error of 0.81%, in Blend 2 mode low 84 V with an error of 0.83%, Medium 86 V with a error of 0.85%, High 105 V with an error of 0.81%, the Cutting mode is low 162 V with an error of 2.88%, medium 172 V with an error of 3.03%, High 192 V with an error of 2.86%. The measurement shows an error of less than 1% for Blend 1 and Blend 2 modes while cutting is less than 3%. The results of this study can be implemented in order to minimize errors due to lack of power settings and mode selection during surgery.

Bipolar or monopolar electrosurgery in blepharoplasty: A comparison of surgical outcomes and patient satisfaction.

An electrosurgery unit (ESU) is the mainstay of bleeding control in blepharoplasty. There are two different types of ESUs: monopolar (m-ESU) and bipolar (b-ESU). We used m- and b-ESUs in upper, lower, and combined blepharoplasty and compared their outcomes. In this retrospective file review of 292 blepharoplasty patients, we excluded 14 who were lost to follow-up or had missing data; among the 278 enrolled patients, we recorded operative time, a surgeon panel's score for edema and ecchymosis on the third postoperative day, patients' scores of their satisfaction and inconvenience, and postoperative complications. One hundred thirty-nine patients were included in the m-ESU and b-ESU group. Overall, 105 patients underwent upper blepharoplasty, 77 underwent lower blepharoplasty, and 96 underwent combined blepharoplasty. The total mean operative time in the m-ESU and b-ESU was 67.94 and 62.82minutes, respectively. This difference was not significant (P>.05). The panel's edema and patient satisfaction and inconvenience scores were significantly better in the b-ESU group (P<.05). There were no significant differences in the panel's ecchymosis score and frequency as well as nature of complications between the m-ESU and b-ESU group (P>.05). In this cohort of blepharoplasty patients, minimally invasive b-ESUs were efficient in obtaining reliable surgical results with higher satisfaction and lower inconvenience rates of patients than m-ESUs. We would like to recommend the use of b-ESUs in blepharoplasty, especially for plastic surgeons inexperienced in periorbital esthetic surgery.

Extending cervicoplastic surgery: an alternative technique to overcome the limitation of office hysteroscopy

Our objective is to show a feasible approach to the hysteroscopic procedures when the cervical canal has a diameter smaller than the lesion. Our study is designed as a case series and illustration of the surgical hysteroscopic technique. A group of patients (n = 37) underwent office hysteroscopy in Regional Reference Center for Hysteroscopy Service at Palagi Hospital, Florence, Italy, to see and treat an endometrial polyp with unfavorable cervical conditions between January 2019 and December 2019. An office hysteroscopy in outpatient setting with vaginoscopic approach was performed in women with unfavorable cervical conditions. Fiber-based 3.5-mm hysteroscope, with 5F electrosurgery unit and 5F bipolar electrode, was used to perform the cervicoplasty in order to enlarge the cervical canal from internal to external os, following by the removal of the endometrial polyp with the excision of the base only without slicing. After 90 days, a follow-up hysteroscopy was performed. The procedure was performed successfully in 89.2% of patients.The surgical technique of cervicoplastic allows to perform an operative procedure without analgesia/sedation or anesthesia or blind cervical dilation, reducing the risk of complications and costs. Furthermore, cervicoplasty allowed the removal en bloc of the endocavitary lesion in all cases. At the follow-up hysteroscopy, the cervical passage was straight and smooth, without lesions repaired in all patients. Cervicoplasty is a technique which allows to perfume an ease and comfortable hysteroscopic procedure even in patients with unfavorable cervical canal. Due to the widening of the diameter of the cervical canal, intracavitary lesions are removed intact resulting in an optimal pathological evaluation.

Gingival hyperplasia as an emanation of wire and braces: A case report

Gingival hyperplasia, hypertrophy & gingival overgrowth are all synonymous terms for the abnormal overgrowth of gingival tissues. A male patient aged 19 years presented with chronic inflammatory gingival enlargement in upper & lower arch associated with prolonged orthodontic therapy. Surgical therapy was performed after scaling and root planing to provide a good aesthetic outcome. Two different surgical treatment modalities were performed in this case, one by using scalpel and second by electrosurgery unit which were compared to evaluate the effect on wound healing & tissue handling properties. Even though scalpel remains a gold standard, electrosurgery showed advantageous over the scalpel for treatment of gingival hyperplasia associated with orthodontic patients. Keywords: Aesthetics, Gingival hyperplasia, Electrosurgery, Non surgical, Surgical, Scaling root planing.

Application of Electrosurgical Units by Operating Room Personnel: Development and Psychometric Testing of an Instrument

Background: Today, electrosurgical units are an indispensable part of surgeries. Yet, inappropriate application of this equipment can result in dire consequences for both the patient and the surgical team. Objectives: The present study aimed at developing the psychometric properties of a checklist to evaluate the application of electrosurgery units by operating room personnel. Methods: The present methodological study was performed in two stages: first, the items of the checklist were developed based on a literature review and search in relevant websites; and second, the psychometric properties of the checklist were measured using the methods to evaluate face, content, and construct validities. The reliability was measured through an assessment of the internal consistency of the checklist, based on the degree of inter-rater agreement. To assess construct validity, the researchers compared known groups; 40 surgeries were observed in two university hospitals in the intervention and control groups. Results: The content validity index (CVI) of all the items was over 0.79. The average CVI (S-CVI/Ave) of the checklist with 32 items was 0.97. The results of the Wilcoxon test showed that the posttest performance scores of the personnel in the intervention group were significantly higher than their pretest scores (P value = 0.005). The internal consistency (the Kuder-Richardson coefficient) of the checklist was 0.66. Conclusions: Due to the great importance of appropriate application of electrosurgery units, a reliable instrument is needed to assess personnel’s performance in this area. The results of the current study showed that the present instrument is sufficiently valid and reliable to evaluate the application of electrosurgical units by the operating room personnel.

Electrosurgery Unit Monopolar (Cutting and Coagulation)

Electrosurgery Unit is a medical device that utilizes high frequency and voltage used to cut and dry tissue during the surgical process. The purpose of making this tool is to damage certain body tissues by heating the tissue. Heat is obtained by concentrating high frequency electricity on certain body tissues using active and passive electrodes as a medium. The Electrosurgery Unit involves the use of the CMOS 4069 IC as a frequency generator. The output frequency is set at 300 KHz then forwarded to the pulse regulating circuit and controlled with ic atmega328 then forwarded to the inverter circuit which functions to increase the voltage and output in the form of power. The module is calibrated using ESU Analyzer. This module is equipped with LOW, MEDIUM, HIGH. After the measurements are made, the more load is given higher to the tool, the higher the power released by the tool in each power selection. Then the load relationship and the power released are directly proportional. This ESU was made so that during the surgical process the body's tissue does not experience a lot of blood loss. Besides being able to use it for surgery, it can also be used to close the tissue after surgery.

Successful outcomes of a new combined solution of hyaluronic acid, chondroitin sulfate and poloxamer 407 for submucosal injection: animal survival study.

Background and study aims Endoscopic resection requires use of submucosal injection. This study was conducted to assess efficacy and impact on early healing of hyaluronic acid combined with chondroitin sulfate and poloxamer 407 (Ziverel) when used as a solution for submucosal injection. Materials and methods Prospective and comparative study of gastric endoscopic mucosal resection (EMR) with three groups of two Yorkshire pigs. Six submucosal cushions were created in each animal by injecting 2 mL of Ziverel (Group 1) or succinylated gelatin (SG) (Group 2), enabling 12 EMR in each group. Submucosal cushions were created with Ziverel in Group 3, without resection. Electrosurgery unit settings were the same in all cases. EMR defects and injection sites were marked with clips. The animals were sacrificed 7 days later. EMR specimen size and duration of procedure were recorded. EMR specimens and EMR scars and injection sites were evaluated by a blinded pathologist. Results We successfully performed 24 EMR (15 en-bloc and 9 piecemeal, without differences between groups 1 and 2). Mean EMR specimen dimensions were significantly larger in Group 1 (median 19 mm, range 6 – 40 vs 16.6 mm, range 5‑25; P = 0.019), without changing the electrocautery unit settings. Blinded histopathologist assessment of EMR specimens showed less fibrosis in the submucosa and a trend to fewer cautery artifacts with Ziverel and did not identify any significant differences in early healing of resection sites. Conclusion The combination of Ziverel enables EMR and does not negatively affect early healing.

Back to Basics: Protection From Surgical Smoke: 1.2 www.aornjournal.org/content/cme.

Surgical smoke is formed when energy-generating devices (ie, electrosurgery units, lasers, powered instruments) raise the intracellular temperature of tissue to at least 100ºC (212ºF), causing tissue vaporization in the form of surgical smoke. Surgical smoke contains components that are known health hazards, such as benzene, toluene, hydrogen cyanide, formaldehyde, volatile organic compounds, viruses, and bacteria. There have been case reports of human disease tied to the inhalation of surgical smoke; therefore, it is important for perioperative team members to minimize their exposure and patient exposure. In spite of the health risks, many perioperative departments do not consistently and effectively evacuate surgical smoke. This Back to Basics article provides basic steps that perioperative team members can take to protect themselves and their patients from the harm caused by surgical smoke exposure.

Surgical Smoke: Putting the Pieces Together to Become Smoke-Free: 1.6 www.aornjournal.org/content/cme.

Surgical smoke is generated when tissue vaporizes from the use of various energy-generating devices (eg, electrosurgery units, lasers). Surgical smoke contains toxic gases and vapors that can be hazardous to patients and perioperative staff members. In addition to ocular and upper respiratory tract irritation, surgical smoke can have mutagenic potential. Although many regulatory agencies agree that surgical smoke is dangerous, they have been slow to commit to a firm standard to address the inhalation hazards related to surgical smoke. With the clear evidence supporting the need to filter surgical smoke, perioperative nurses and surgical technologists at our facility implemented a plan to protect patients and staff members. The plan included identifying and evaluating in-house equipment and the perceived barriers to becoming smoke-free. Perioperative personnel tested multiple smoke-evacuating products to determine which best met the needs of our staff members and facility, and our ORs are now smoke-free.

Low cost system to measure active power in electrosurgical units

Abstract Introduction: The real-time measurement of active power delivered to patients during the electrosurgical act is still an engineering challenge. Besides, there is no electrosurgical unit on the market capable of doing it according to the normative requirement. Methods This work presents the design of an electronic structure capable to probe the electrosurgical equipment output electrical signals, using low-costs very common resistors, and High Frequency distortions compensation circuits, and process them to provide an analogue signal proportional to the active power, allowing the knowledge and control of the energy delivered to the biological tissue. The reading circuits and the active power calculation method are presented. The power calculation is performed in two stages. The first one consists of a multiplier circuit that uses the readings voltage and current quantities to determine the instantaneous output power, and the second stage is formed by an integrating circuit which determines the average power value, resulting in a rippled continuous voltage, proportional to the active power delivered to the patient or biological tissue. Results Practical tests of the compensation technical are statistically evaluated by means of linear regressions. Results of 23 tests are summarized in a way to demonstrate de effectiveness of the proposed system. Conclusion Analysis of the results demonstrate the efficiency of the proposed system, whose average error is lower than 5%, and correlating them with the standard IEC 60601-2-2, that regulates the operation of electrosurgery units.

Experimental Investigation of the Effects of 3 Different Electrosurgery Units’ Monopolar and Bipolar Current Modalities on Uterus

Experimental Investigation of the Effects of 3 Different Electrosurgery Units’ Monopolar and Bipolar Current Modalities on Uterus

Harmonic Scalpel and Electrothermal Bipolar Vessel Sealing System in Head and Neck Surgery: A Prospective Study on Tissue Heating and Histological Damage on Nerves.

Define and compare the thermal nerve injury caused by 3 different vessel sealing and dissection devices: the harmonic scalpel (HS), the electrothermal bipolar vessel sealing system (EBVS), and the bipolar electrosurgery unit (BE). First we recorded the heating variations in pig tissue caused by a BE unit, HS, and EBVS after an activation for 5, 10, and 15 seconds at minimum and at maximum power. In the second part, we evaluated the histological damage caused by HS and EBVS on 20 in vivo human nerves, 10 per device. The 2 scalpels were placed and activated at 3 different distances from the nerve (1, 3, and 5 mm). The extension and the degree of the nerve lesion was then calculated. The instrument determining the highest rise in temperature was the BE unit, followed by HS and then EBVS. Comparison between the extension and degree of nerve injury caused by the 2 scalpels showed no statistically significant differences. Based on these evaluations, we established a relative safety limit at 3 mm and an absolute safety limit at 5 mm for both scalpels. Our data suggest EBVS and HS can be considered valid and safe devices for ENT surgery.