ASGE Advanced Endoscopic Lesion Resection Course (On-Demand) | November 2022-8 Amin

8 Amin_Know your electrosurgical unit

Pdf Summary

This document provides an overview of understanding an electrosurgical unit (ESU) used in endoscopic surgery. The author explains the concepts of current density, voltage, and power and how they apply to ESU. The ESU circuit is explained as the flow of electrons through the circuit from the ESU to the active electrode, to the patient, to the pad, and back to the ESU. The document describes different types of ESU generators, including constant voltage, hybrid, and constant power, and their respective functions.<br /><br />The document also covers the differences between pure cutting, pure coagulation, and blended current in endoscopic surgery. It explains the cutting waveform as a sinusoid requiring microelectric "arcing" and the coagulation waveform as spikes of high voltage followed by rest periods. The blended cut, called Endocut I/Q, is described as a mix of cut and coagulation current that produces precise cut and power doses based on circuit impedance.<br /><br />Various settings and techniques for specific procedures are discussed, such as polypectomy, lift and cut EMR, underwater EMR, hot avulsion, snare tip soft coagulation, and hemostasis. The document provides suggested EMR settings for different procedures.<br /><br />In conclusion, the document emphasizes the importance of knowing the ESU generator, modes, and techniques, as well as using high current density for specific procedures. It encourages practitioners to do what they are most comfortable with.

Keywords

electrosurgical unit

endoscopic surgery

current density

ESU circuit

ESU generators

pure cutting

pure coagulation

blended current

EMR settings

high current density