Electro Surgical

Electrosurgery is the use of high frequency electrical energy in the radio transmission frequency band applied directly to tissue to induce histological effects.

Like laser treatment, electrosurgery is thermo-dynamic and develops heat directly within tissue cells. Unlike laser however, electrosurgery works over the entire surface of the electrode tip in contact with tissue, which makes it ideal for sculpting living tissue particularly in prosthodontics.

Electrosurgery used - in two words : soft tissue. In general surgery, electrosurgery is used on nearly every soft tissue in the human body. The energy introduced by electrosurgery reacts with water molecules within the cells of the tissue being treated, therefore, in dentistry it is not effective on hard tissues like enamel or bone.

By means of two electrical connections called "electrodes".

In "monopolar" electrosurgery, one is an "active" electrode and is used to introduce therapeutic current into tissue. These are also called "tips" or "electrode tips" and come in a wide variety of sizes and shapes suited to specific clinical indications for incision, excision, curettage, and coagulation. These are held in an insulated hand piece. The other electrode is the "dispersive" electrode and is in the form of a large flexible pad. "Dispersive" connection to the patient is by means of capacitive coupling which works through normal street clothing without direct skin contact so that the patient reclines against the dispersive pad ( or "plate" ) completing the electrical circuit.

The "active" electrode is many orders of magnitude smaller in surface area that the "dispersive" electrode so that therapeutic current is highly concentrated in the area being treated. In contrast, therapeutic current is distributed over the very large area of the "dispersive" pad such that current density at any point is too low to induce any measurable histological effect, hence the term "dispersive".

In "bipolar" electrosurgery, both electrodes are the same or similar size and are mounted on a common hand piece. No separate dispersive plate or pad is used and the cable from the bipolar hand piece to the electrosurgery unit has two conductors.

About Bipolar,
"Bipolar" refers to two things, a situation which engenders some confusion. First, it refers to a technique where therapeutic current is restrained to the immediate volume of tissue being treated and does not diffuse through the body. Bipolar electrodes are exemplified by bipolar forceps, where the two tips of the forceps are insulated from each other, and two wires connect the forceps to the unit.

Bipolar also refers to the electrosurgical unit itself in terms of RF isolation. "Bipolar" is defined as a greater degree of isolation than "isolated". All products isolated units are rated safe for bipolar coagulation but not for incision or excision. Bipolar accessories are certainly not safe with ground referenced generators.