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BOVIE SPECIALIST ELECTROSURGICAL UNIT
5. Experiments in Electrosurgery
Needle Electrode
-
Now, repeat the above experi-
Cut with Hemostasis
ments, substituting a needle electrode for the flat
blade. The needle, presenting a thicker cutting
edge, will produce greater dehydration on the edges
of the incision, with more resistance and, conse-
quently, slower cutting at the same power setting. A
needle electrode is preferred for incising abscesses
or cysts where drainage is desirable and healing by
primary union is to be prevented by choice. Try
short cross incisions at a CUTTING power of 2, a
type of incision used particularly for an abscess or
cvst. A areater hemostatic effect will probably be
noticed k i t h the needle electrode since it is most
difficult to perform small incisions with great speed.
Loop Electrode
-
Next, try "scalloping" out bits of
tissue or looping off simulated neoplasms with a
loop electrode. Depending on the size of loop and
clinical effects desired, CUTTING power should be
set at 2-3 for scalloping, with higher settings re-
quired for larger or deeper areas. Loop and needle
electrodes tend to build up coagulum easily. After
several trials, cleaning or replacing the loop would
give more indicative performance. A small area of
the loop should be utilized for initial contact since a
larger area of starting contact could cause coagula-
tion to occur, crusting the loop and making inci-
sions clinically unpredictable.
CUT WlTH LOOP ELECTRODE
Contact the tissue lightly with asmall section of
the loop before turning on the current. Step on the
footswitch and start movement of the loop imme-
diately. If too much of the loop contacts the tissue or
it you wait too long with current on before moving
the loop, coagulation will retard or prevent cutting.
Cut into, through, and out of the tissue. It is quite an
art to bring the loop away from the tissue with the
piece completely excised. The final thin tab of tissue
will resist severance unless the loop is handled just
right. Practice makes perfect.
The wire loop of the electrodes will bend to
various angles or curve to required shapes other
than round. There is no need to be equipped with
loops of varied shapes or angulation.
The experiments carried out in electrosection
Pure Cut may be repeated with the CUTTING type
switch turned to CUT WlTH HEMOSTASIS. Cut
with Hemostasis is a blend of pure cut currents and
coagulating currents, and may require a slightly
higher power setting for each electrode used since
the hemostasis current must, of necessity, be a
pulsed waveform. Pulsing will reducecutting ability
unless the power control is increased to a setting
compatible with clinical requirements.
Comparison of parallel incisions on the meat in
PURE CUT and in the CUT WlTH HEMOSTASIS
position will verify the ease of cutting in PURE CUT
and the tendency to drag slightly in CUT WlTH
HEMOSTASIS. Use one power control setting for
both modes of electrosection and compare the
clean incision of Pure Cut with the dehydration
occurring in Hemostasis.
EXPERIMENTS WlTH COAGULATION
Coagulation and fulguration are probably the
most used techniques with electrosurgical instru-
ments i n office practice. The BOVIE Specialist is the
forerunner of a new coagulation current waveform
which appears to be not only a cooler method, but
also has greater desiccation capabilities with less
power requirement. In coagulation, power levels,
timing, electrode size and skill of application are
requirements for good clinical results.
Needle Electrode
The uniqueness of the Specialist coagulating
current waveform can be appreciated if the first
experiments are initiated at low power levels. Insert
the needle electrode i n the chuck handle, set
COAGULATING power at 1.5 and insert needle
electrode to a
1/4
inch depth. Apply power. It will be
noted that a ring of coagulated tissue will form at the
surface of the meat. If power is kept applied, spark-
ing will occur. Sparking under these conditions
indicates loss of conductive tissue and the coagula-
tion voltage now is applied to a higher resistance or
impedance. Unless superficial dehydration is the
clinical requirement, timing is important so that
necrosis is accomplished without excessive arcing.
Continued
. . . . . . .
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