First Year Fellows Endoscopy Course (July 29 - 30)

Video Transcription

Video Summary

In this video, Dr. Joel Munzer, a professor at Medical University of South Carolina, gives a talk on electrocautery. He begins by discussing his own experiences with electrocautery and the importance of understanding the big picture rather than focusing on granular details. He explains that electrocautery is a misnomer in gastrointestinal endoscopy as the term actually refers to a device that heats tissue by transmitting heat from the device itself. The proper term for this process is electrosurgery. Dr. Munzer then delves into the fundamental purpose of an electrosurgical generator, which is to produce high-frequency AC or alternating current to heat tissue. He explains how AC current is delivered without electrocuting or shocking the patient, noting that frequencies above 100,000 hertz do not stimulate the nervous system. Dr. Munzer discusses the two main tissue effects of electrosurgery, which are cutting and coagulation. Cutting occurs at high voltages, causing cells to burst, while coagulation occurs at lower voltages, causing cells to shrink and dry out. He emphasizes the importance of understanding different electrosurgical currents and their effects on tissue, as this knowledge can help in troubleshooting and ensuring patient safety. Dr. Munzer also touches on the use of grounding pads and the potential risks of monopolar current for patients with pacemakers or ICDs. He concludes by discussing the use of argon plasma coagulation (APC) , a non-contact form of electrosurgery that uses argon gas and ionized electricity to deliver current to tissue. He highlights the importance of equipment understanding and encourages fellows to develop a good working knowledge of electrosurgical currents and their effects on tissue to ensure safe and effective procedures.

Asset Subtitle

B. Joseph Elmunzer, MD

Keywords

electrocautery

electrosurgery

gastrointestinal endoscopy

cutting

coagulation

patient safety