First Year Fellows Endoscopy Course (July 29 - 30)

3-Electrocautery

Pdf Summary

The document provides an overview of the use of electrocautery in endoscopy. It explains the basic terms related to electrosurgery, such as current, voltage, and circuit. The document also discusses the purpose of an electrosurgical generator, which is to produce high frequency alternating current that can be used for cutting and coagulation. It differentiates between monopolar and bipolar circuits and explains the principles of how heat is produced during electrosurgery.<br /><br />The document goes on to describe the thermal effects of electrosurgery on cells, including reversible and irreversible cellular trauma, coagulation, cutting, and carbonization. It mentions the different temperature/thermal effects that can be achieved by changing the waveform. <br /><br />The function and placement of the grounding pad, as well as guidelines for its safe use, are also discussed. The document mentions potential considerations for patients with pacemakers or ICDs and provides recommendations for their management during electrosurgery procedures. <br /><br />Argon Plasma Coagulation (APC) is introduced as a non-contact method that uses ionized argon gas to deliver monopolar current to the tissue. The advantages of APC, including its ability to seek the best area of conductivity, provide even and uniform coagulation, and create a thinner eschar, are mentioned. The document also identifies various applications of APC, such as the treatment of vascular ectasias, tissue ablation, and as an adjunct to fistula closure.<br /><br />Furthermore, the document emphasizes the responsibility of physicians to understand and set up the equipment used for electrosurgery, urging them to become familiar with their current generator and electrocautery devices.

Keywords

electrocautery

endoscopy

electrosurgery

current

circuit

thermal effects

grounding pad

argon plasma coagulation

tissue ablation

physicians