Energy Devices: Working Principles, Uses And Complications

In ancient times, a hot iron rod was used for charring at the bleeding site to stop bleeding. The earliest significant contribution to a sophisticated method of generating heat to cauterize tissue from electrical current is by Bovie. Energy sources are classified as radiofrequency electrosurgery, laser, ultrasonic, and argon beam coagulation. The majority (85%) of surgeons use monopolar electrosurgery. The electrosurgical effect on the tissue causes cutting, coagulation, fulguration, and desiccation. It uses ultrasonic technology, the unique energy form that allows both cutting and clotting at the precise point of impact, resulting in minimal lateral thermal tissue damage. Cutting and coagulation are done at lower temperatures than those used by electrosurgery or lasers. The Harmonic Scalpel has five power levels. Increasing the power level increases cutting speed and decreases coagulation.

In contrast, less power reduces cutting speed and increases clotting. Argon-enhanced electrosurgery incorporates a stream of argon gas to improve the surgical effectiveness of the electrosurgical current. Argon gas is inert and non-combustible, making it a safe medium to pass electrosurgical current.