Don't be afraid of being 'burned by the current'! Let's learn about Electrosurgery.

Have you ever heard someone say, “The current stopped the bleeding ” during an operation? Or have you ever seen a doctor apply a small device to the area to remove something like a mole or a tumor? This treatment method, which sounds a little scary when you hear the name, is called `Electrosurgery` in medical science. Although this name may sound like a big deal, it is actually a very widely and safely used technique in surgeries all over the world. So, let's talk about it precisely and simply today.

Simply put, what is Electrosurgery?

Electrosurgery is a surgical procedure that uses high-frequency electric current to cut tissue, destroy unwanted tissue, or stop bleeding (coagulation). In this, electricity generated by a machine called an ``Electrosurgical Unit (ESU)`` is sent to a small pen-like device (electrode) that the doctor uses. When the electricity from this device is directed at the area being treated, heat is generated as the electricity passes through the tissue.

The heat generated in this way damages those unwanted tissues. But this damage is what helps us. Using this method, we can remove unwanted growths and warts on the skin. It is also used to close small blood vessels that are cut during an operation and stop bleeding. Sometimes it is done as a stand-alone treatment, and other times it is done in combination with other treatments.

What are the main types of electrosurgery?

There are several types of this method designed to suit different needs. Let's see what they are.

Is electrocautery something different?

Yes, ` electrocautery` is a slightly different method. In electrosurgery, electricity passes directly through the body's tissue. But in electrocautery , electricity passes only through the tip of the instrument. So the tip of the instrument heats up. Then, when that heated tip touches the tissue, the direct heat destroys the tissue or stops the bleeding. Simply put, in one case, electricity passes through the tissue, in the other, a heated instrument is used.

What types of conditions is this method used for?

Electrosurgery is something that is used in many medical fields.

• Dermatology: Dermatologists often use this technique. It is very effective in removing benign lesions such as warts and skin tags . It is also used to treat some types of skin cancer . For example, in an ED&C (Electrodessication & Curettage) procedure, the doctor first scrapes away the cancerous lump and then uses electrosurgery to destroy any remaining cancer cells .
• Other surgeries: This is essential in other surgeries, especially those involving endoscopy (examinations using a camera to look inside the body), to remove unwanted tissue (e.g., small tumors) or to control bleeding .

What happens during treatment?

First, you will be given a numbing medication to numb the area being treated, or you may be completely anesthetized . What happens next depends on whether you are having `monopolar` or `bipolar`.

Monopolar Electrosurgery

This is the method most often used. “Mono” means “one.” Here, only one electrode tip is applied to your body.

1. Electricity from the ESU machine comes to the active electrode (the pen-like device in the doctor's hand).

2. This electricity passes through the tissues of your body and heats that area.

3. The electricity then travels through the body and goes to a “grounding pad” (dispersive electrode) that is attached to your thigh or elsewhere.

4. Finally, the electricity from that grounding pad goes back to the ESU machine, completing the circuit.

Bipolar Electrosurgery

“Bi” means “two.” In this, two electrode tips are applied to your body. Imagine that the doctor is holding the tissue being treated with a forceps-like device.

1. Electricity enters the tissue from one side of the electrode (active electrode).

2. That electricity travels a very short distance through the tissue and then goes to the other side of the electrode (return electrode).

3. From there, the electricity goes back to the ESU machine, completing the circuit.

What are the advantages of this method?

Electrosurgery is a method that has several advantages over simply cutting with a scalpel.

• Targeted treatment: There is minimal damage to surrounding healthy tissue.
• Reduced scarring: The amount of scarring caused by tissue removal is reduced.
• Speed: Tissue destruction (ablation) can be done quickly.
• Stopping bleeding : Bleeding can be stopped very quickly, reducing the time spent in surgery.

Are there any side effects or risks?

This is a very safe procedure when performed by an experienced doctor. However, as with any medical procedure, there are some risks involved. However, doctors take every step to minimize these risks.

• Burns: If the power of the electric current seems too high, burns may occur. To prevent this, doctors always start with the lowest possible power .
• Electric shock: If the grounding pad is not connected properly, you may get an electric shock. However, the chance of this happening is very low, as everything is checked thoroughly before treatment.
• Infections: Infections can occur if the equipment used is not properly sterilized. Also, germs can spread through the smoke produced when tissue is burned. For this reason, doctors use only sterilized equipment and perform these treatments in rooms with smoke ventilation systems.
• Bleeding:Sometimes, tissue damage can cause more bleeding than expected, but the doctor can control it by changing the settings on the ESU machine.
• Skin discoloration: After some types of electrosurgery, the skin may become whiter in the treated area (hypopigmentation). Your doctor will explain to you in advance whether there is a risk of this from the treatment.
• Problems with implanted devices: As mentioned earlier, the Monopolar method in particular can interfere with the functioning of electronic devices such as pacemakers and defibrillators. If you have such a device, you should definitely inform your doctor before the surgery. Then they will choose the safest method for you.

How long will it take to heal?

This depends on the nature of the treatment.

• If something like a mole or tumor on the top layer of the skin is removed, it will take about a week for the wound to heal.
• If it's a deeper wound, it could take two to four weeks or more.

The doctor will explain to you the recovery time based on your condition.

When do you need to see a doctor?

After treatment, if your wound is bleeding and has not stopped after 20 minutes of continuous pressure, call your doctor immediately. If the bleeding is heavy, go to the Emergency Department (ETU) of the nearest hospital.

Also, if the wound seems to be festering, there is a lot of pain, or if you feel like it is not healing as expected, don't delay in talking to your doctor.