Electrosurgery is widely used in the practice of otolaryngology—head and neck surgery. Despite its popularity, few training programs give formal education in the optimal use of electrosurgical instruments. This article reviews the history, physics, and tissue effects of these commonly used devices. Armed with this knowledge, the head and neck surgeon can take full advantage of electrosurgery's ability to dissect tissues with precision and minimal blood loss.
GloverJLBendickPLLinkWJ. The use of thermal knives in surgery: electrosurgery, lasers, plasma scalpel. Curr Probl Surg1978; 15: 1–78.
2.
KrusenFH. William Gilbert, the father of electrotherapy. Arch Phys Ther X-ray Radiol1931; 12: 737–43.
3.
D'ArsonvalA. Action physiologique des courants alternatifs. J Compt Rend Soc Biol Paris1891; 43: 283–6.
4.
D'ArsonvalA. Action physiologique des courants alternatifs a grande frequence. Arch Physiol Norm Pathol1893; 5: 401–8.
5.
NagelschmidtCF. Zur Indikation der Behandlung mit Hochefrequenzstromen. Dtsch Med Wochenschr1907; 33: 1289–91.
6.
DoyenD. Sur la destruction des tumeurs cancereuses accessibles par la methode de la volaisation bipolaire et de l'electro-coagulation thermique. Arch Elec Med1909; 17: 791–5.
ClarkWL. Oscillatory desiccation in treatment of accessible malignant growths and minor surgical conditions; new electrical effect. J Adv Therap1911; 29: 169–83.
10.
CushingH. Electrosurgery as an aid to the removal of intracranial tumors. Surg Gynecol Obstet1928; 47: 751–84.
SebbenJE. Cutaneous electrosurgery. Chicago, Ill: Year Book Medical Publishers, 1989: 33, 43, 139–75.
14.
LawrensonKBStephensFO. The use of electrocutting and electrocoagulation in surgery. Aust N Z J Surg1970; 39: 417–21.
15.
MaddenJWAremAJ. Wound healing: biologic and clinical features. In: SabistonDC, ed. Textbook of surgery. Philadelphia, Pa: WB Saunders, 1981: 265–86.
16.
RappaportWDHunterGCAllenR. Effect of electrocautery on wound healing in midline laparotomy incisions. Am J Surg1990; 160: 618–20.
17.
RosinRDExarchakosGEllisH. An experimental study of gastric healing following scalpel and diathermy incisions. Surgery1976; 79: 555–9.
18.
LinkWJGloverJLEdwardsJLHendersonMRYawPBIncroperaFP. Wound healing of mouse skin incised with a plasma scalpel. J Surg Res1973; 14: 505–11.
19.
LinkWJIncroperaFPGloverJL. A plasma scalpel. Comparison of tissue damage and wound healing with the electrosurgical and steel scalpels. Arch Surg1976; 111: 392–7.
20.
ChenRJLeeEFShihJC. Does the loop electrosurgical excision procedure adversely affect the histopathological interpretation of cervical conization specimens?Acta Obstet Gynecol Scand1994; 73: 726–9.
21.
MausbergRViesserHAschoffTDonathKKrugerW. Histology of laser- and high-frequency-electrosurgical incisions in the palate of pigs. J Craniomaxillofac Surg1993; 21: 130–2.
22.
MiddletonWGOstrowskiM. Comparative gross and histological effects of the CO2 laser, Nd-YAG laser, scalpel, Shaw scalpel and cutting cautery on skin in rats. J Otolaryngol1993; 22: 167–70.
23.
MolgatYMPollackSVHurwitzJJ. Comparative study of wound healing in porcine skin with CO2 laser and other surgical modalities: preliminary findings. Int J Dermatol1995; 1: 42–7.
24.
BohmBMilsonJWKitagoKBrandMFazioVW. Monopolar electrosurgery and Nd:YAG contact laser in laparoscopic intestinal surgery. Surg Endosc1994; 8: 677–81.
25.
LucianoAAFrishmanGNMairDB. A comparative analysis of adhesion reduction, tissue effects, and Nd: YAG laser at operative laparoscopy: an animal study. J Laparoendosc Surg1992; 2: 287–92.
26.
EdlichRFTsungMRogersWRogersPWangensteenOH. Studies in management of the contaminated wound. I. Technique of closure of such wounds together with a note on a reproducible experimental model. J Surg Res1968; 8: 585–92.
27.
MaddenJEEdlichRFCusterJRPanekPHThaulJWangensteenOH. Studies in the management of the contaminated wound. IV. Resistance to the infection of surgical wounds made by knife, electrosurgery, and laser. Am J Surg1970; 119: 222–4.
28.
KenanKMRodeheaverGTKenneyJGEdlichRF. Surgical cautery revisited. Am J Surg1984; 147: 818–21.
29.
DuffyS. The tissue and thermal effects of electrosurgery in the uterine cavity. Baillieres Clin Obstet Gynaecol1995; 9: 261–77.
30.
ZoharYSadovRStraussMDjialdettiM. Ultrastructural study of peripheral nerve injury induced by monopolar and bipolar diathermy. Ann Otol Rhinol Laryngol1996; 105: 673–7.
31.
MannDGSt GeorgeCScheinerEGranoffDImberPMlynarczykFA. Tonsillectomy — some like it hot. Laryngoscope1984; 94: 677–9.
32.
LeachJManningSSchaeferS. Comparison of the two methods of tonsillectomy. Laryngoscope1993; 103: 619–22.
SwansonNAJohnsonTM. Management of basal and squamous cell carcinoma. In: CummingsCWFredricksonJMHarkerLAKrauseCJSchullerDE, eds. Otolaryngology—head and neck surgery. St Louis, Mo: Mosby, 1993: 403–5.
35.
MitchellJPLumbGNDobbieAK. A handbook of surgical diathermy. Bristol, England: Wright & Sons, 1978: 44–59.
36.
TanSKHinbergI. Temperature distribution beneath pediatric electrosurgical dispersive electrodes: a model study. Biomed Instrum Technol1993; 27: 506–13.
37.
HarringtonDP. Electrosurgery fact and fiction. Biomed Instrum Technol1994; 28: 331–3.
38.
BondWH. Electrical hazards of disposable monitoring electrodes. Lancet1975; 1: 852–3.
39.
Electrical safety in the operating room [Editorial]. JAMA1973; 224: 1287.
40.
SebbenJE. Electrosurgery and cardiac pacemakers. J Am Acad Dermatol1983; 9: 457–63.
WajszczukWJMowryFMDuganNL. Deactivation of a demand pacemaker by transurethral electrocautery. N Engl J Med1969; 280: 34–5.
43.
HungerbuhlerRFScopeJPRevesJG. Ventricular fibrillation associated with use of electrocautery. A case report. JAMA1974; 230: 432–5.
44.
TzimaEMartinCJ. An evaluation of safe practices to restrict exposure to electric and magnetic fields from therapeutic and surgical diathermy equipment. Physiol Meas1994; 15: 201–6.
45.
KellerCElliotWHubbellRN. Endotracheal tube safety during electrodesiccation tonsillectomy. Arch Otolaryngol Head Neck Surg1992; 118: 643–5.
46.
WinstinC. The effect of smoke plume generated during laser and electrosurgical procedures. Minim Invasive Surg Nurs1994; 8: 99–102.
47.
BaggishM. Presence of human immunodeficency virus DNA in laser smoke. Lasers Surg Med1991; 11: 197–203.
