Electrosurgical methods of treatment

Electrosurgical methods of treatment - division, excision or destruction of tissues with the help of high-frequency currents (up to 600-700 thousand oscillations per second). High frequency currents are generated (produced) special thermal units (see Diathermy) and do not cause irritation of tissues, increasing at the end of the active electrode temperature about 70-80 degrees.
All manipulations on the fabrics are made using the active electrodes with different shapes and sizes, specifying their purpose (see Electrosurgical instruments). Passive (indifferent) electrode is a lead plate 20x15 cm in thickness of 1 mm, which is tight bandage to the outside of the thighs, legs or back.
In electrosurgery are also used biactive electrodes, consisting of two identical size small metal plates between which place the tissue that is subject electrocautery, often small benign tumors (fibroma, papilloma, angioma and others). When this technique passive electrode in the form of lead plates are not used. Biactive electrodes in the form of scissors, scalpels, etc. can also be used for bloodless dissection of tissue tumors; wide dissemination in practice they have not yet received.
Electrosurgical methods of treatment are reduced to two main ways of impacts: electrocautery - burned, the clotting proteins tissues (see Diathermocoagulation) and elektrochemie - dissection and tissue excision. There are two methods of electrohimii: electrocute and electrocoagulation. The first is using a thin lanceolate or needle electrode; with the rapid conducting it is instantaneous linear fusion and separation of tissues on the surface of such a "Electronista" is formed only a very thin layer of coagulated non-viable tissues, do not prevent the healing of wounds primary intention. Electrocoagulation produce thicker electrocautery carried out slower, so on the surface of the wound remains a significant area of coagulated tissues; this method is used mainly in anticipation of wound healing by second intention after the rejection of necrotic layer. Sometimes the wound is sutured, but in this case its healing is delayed for more than 3 weeks.
Manipulation with electrosurgical methods of treatment near cartilage, bone and blood vessels large caliber are known danger. Advantages electrosurgical methods of treatment: hemostasis (stopping the bleeding of small vessels), blockage of lymphatic ways, reducing pain in the wound (due to coagulation crossed nerves).
When electrosurgical operations concerning removal of the tumor is the destruction of cancer cells remaining in the walls of the wound. Especially shown electrosurgical methods of treatment is considerable local spread of malignant tumors with fuzzy boundaries (for example, infiltrating breast cancer). Electrosurgical methods of treatment are widely used in the treatment of benign tumors and precancerous conditions.
Electrosurgical methods of treatment are widely used in other fields of medicine: in ophthalmology (removal of the eyelashes and others), in dermatology and medical cosmetics (removal of pigmented and vascular birthmarks, warts, tattoos and other), dentistry (excision of various tumors of the tongue, and others), in otorhinolaryngology (coagulation angiomas and other tumors in the nose, larynx, vocal cords, and others). When pulmonary tuberculosis widely used elektrochemie for dissection pleural adhesions. Electrosurgical intervention performed by a physician; the nurses prepares the patient for surgery and the necessary tools.

Electrosurgical treatment methods (electrosurgery) - division, excision or destruction of tissues with the help of high-frequency currents. Acting factor is the heat growing in the tissues of endogenous due to the resistance of passing current.
High frequency currents in contrast to the usual technical-current does not cause in colloid and liquid environments tissues of electrolytic dissociation, making even at high current does not irritate the nervous system and therefore does not cause shock. They are generated in special thermal devices, which is why Electrosurgical treatment methods originally was named surgical diathermy (see Diathermy).
The first type of surgery was fulgurate. On a place of destruction (various skin processes, tumor) through the hollow tubular electrode connected to the device, giving much ringing of high frequency and voltage, has sent a beam of sparks. The impact of fulguralis was too superficial and was soon abandoned. However, this form of treatment is applied at present in the form of electrodesiccation with changed as sparks, its small size. The fabric is dried according to the indications until charring (carbonization). Apparatus for such impacts are mainly used in cosmetic surgery.
Electrosurgical methods of treatment are reduced to two main ways of influences : electrohimii (synonym of Deuteronomy) - dissection and tissue excision and electrocoagulation [synonym diathermocoagulation (see)] - welding, the clotting proteins tissues. For both purposes are constructed vehicles almost exclusively for bipolar (two-polar) applications.
If electrohimii the development of extremely high temperatures under the tip of electrocautery, needle or the edge of a wire loop water tissues instantly turns into steam, which breaks the cell membrane, and a fabric gives way in the direction of the reference electrode. At sufficiently high current and quick motion of the electrode is cut with invisible subtle coagulation film edges (akatemia); at a more moderate current and slow conducting electrode dissection is not as quickly and astroplanes wound edges, the more pronounced the longer intervention (coagulatory).
Electrosurgical methods of treatment applied in many branches of medicine because of the extremely wide range electrosurgical impacts: in ophthalmology - for epilation eyelashes, coagulation areas sclera with retinal detachment; in dermatology and medical cosmetics - for removal of pigmented and vascular birthmarks, warts, volosatoi, tattoos and other; in dentistry - for coagulation dental pulp, sterilization of dental channels, eliminating papillomatosis gums, lakoplakii mucous membranes of the oral cavity, excision of various kinds of tumors of the tongue, and so on; in otolaryngology - coagulated angiomas and other tumors in the nose, larynx, vocal cords, aseptically tonsils with tonsillitis, etc. In the treatment of pulmonary tuberculosis widely used elektrochemie pleural cords and commissure through thoracoscopy. In some cases the electrocoagulation use for removal of polypous growths and small bronchial adenomas through the bronchoscope; in General surgical clinic widely used electrocoagulation to stop bleeding, with extensive incision tissues, such as when thoracic operations, which significantly reduces the duration of interventions and the amount left in the tissues of foreign bodies - ligatures. During operations on the gastrointestinal tract electrosurgical treatment methods reliably provide the asepsis intervention, which in these cases produce almost without opening gaps bodies or become the edge of the cross-section of a hollow organ. Justified itself electrosurgery with liver resection; in some cases, severe changes inside the gallbladder and you can't delete the proposed operation mukalazi - electrocoagulation and scraping mucous membrane of the bubble; in urology the electrocoagulation is used for the treatment of ureterocele and when incursion stone at the mouth of the ureter, and also in prostatic hypertrophy.


The greatest application electrosurgical treatment methods found in Oncology. This is due to the following features electrosurgery: the death of all living cells under the active electrode allows to operate more ablation and aseptico; education if electrohimii on the surface, dissected tissue coagulation film protects against vaccinations on them tumor cells, who happened to be alive, and from local recurrence; the covering crossed the lymphatics and interstitial of gaps prevents the penetration into them of tumor cells and metastasis, and absorption of toxic substances from the lost tissue, which eliminates secondary osteoclast shock; coagulation of the walls of small blood vessels decreases blood loss, which reduces the risk of shock and allows extended to operate even debilitated patients; the destruction of all axial cylinders are a lot of nerves and shelter them coagulated protein does not allow admission to them irritation and protects from the secondary shock. This promotes more active patients and helps the body recover quickly after surgery.
Electrosurgical treatment methods proved to be very effective in surgery of tumors of the brain, the cerebellum, as they allow to delete with the least injury deep seated tumours.
Nude tumor stage coagulated biactive-bipolar way and take out coagulated part of Electrometry. Almost full bloodless intervention allows you to perform an operation under visual control. Also proposed coagulation of the choroid plexus of the ventricles of the brain to reduce the secretion of the cerebrospinal fluid with edema of the brain.
Electrosurgical treatment methods may be the only effective in advanced cancer of the skin, lip, upper jaw, and when surgical, and radiation therapy seem hopeless. However, there was widespread combined technique - Elektroapparate with prior or subsequent radiotherapy. This greatly increased the effectiveness of treatment for cancers of the tongue, in infiltrative forms of breast cancer, malignant neoplasms of the upper jaw.
Electrosurgical treatment methods are the method of choice in the treatment of bladder papillomas and initial stages of cancer (endo - and Transbaikalye electrocautery and electroresection bubble). Electrocoagulation and electroconsult cervix when thrust her erosion are also the method of choice and good preventive remedy to precancerous her illness. The times is the best operational intervention in cancer of the vulva.
Low-set, neudalimye usual way cancers of the rectum and relapse can be cured (sometimes for a long time) by its dorsal splitting intestine, coagulation tumors and bailing coagulated tissues Electrometry. Widely use the times and in the treatment of malignant melanoma of the skin and soft tissue sarcomas.