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Surgical biology and methods > Electrosurgical devices > Flashcards

Electrosurgical devices Flashcards

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1
Q

What is the equation for voltage?

A

V (Volts) = I (Amperes) x R (Ohms)

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2
Q

What is the equation for power?

A

Power (Watts) = V(Volts) x R(Ohms)

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3
Q

Describe the difference in oscillating high frequency waveform between cut and coagulation modes in electrosurgery?

A
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4
Q

Describe the different tissue effects of electrosurgery based on temperature?

A
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5
Q

During coagulation waveforms for what percentage of the time is current available?

A

6% of the time, with the remaining 94% of the cycle being tissue cooling

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6
Q

What tissue temperatures are involved in electrosurgical tissue cutting?

A

Sparking between the electrode and target tissue results in tissues in excess of 100 degrees, resulting in vaporization and cell rupture.

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7
Q

What are the three different tissue effects based on coagulation waveform and contact type?

A
  1. Fulguration - high voltage sparking results in carbonization.
  2. Dessication - direct contact results in tissue dehydration and protein denaturation.
  3. Coaptive - lumen of vessel is occluded with instrument and application of current to the instrument results in denaturing of adventitia and collagen weld.
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8
Q

What are the components of a monopolar electrocautery system?

A

Generator, electrode, grounding pad

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9
Q

What size vessels can monopolar electrocautery successfully seal?

A

2mm

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10
Q

Why does liquid prevent appropriate functioning of monopolar electrocautery?

A

Liquid disperses the current

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11
Q

Does bipolar electrosurgery use higher or lower voltage and power settings compared to monopolar?

A

Lower power and voltage which minimizes collateral tissue damage, but prolongs application of the device.

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12
Q

What process is involved in coagulation with bipolar vessel sealing devices?

A

Vaporization as temperatures exceed 100 degrees. Carbonization can occur if temperatures exceed 250 degrees.

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13
Q

What are the three potential mechanisms of injury with use of monopolar electrosurgical units during MIS?

A
  1. Insulation failure
  2. Direct coupling
  3. Capacitive coupling
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14
Q

What size vessels are EnSeal and LigaSure able to seal?

A

Up to 7mm

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15
Q

What is the main difference between LigaSure and EnSeal?

A

EnSeal maintains temperatures of 100 degrees between the jaws, limiting thermal spread to 2mm. In a porcine study Ligasure collateral thermal damage extended 1-3mm.

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16
Q

How does the use of ultrasonic or harmonic scalpels result in coagulation?

A

Protein denaturation leads to formation of a coagulum that seals vessels.

17
Q

What are the primary differences between ultrasonic energy systems and bipolar vessel sealing devices?

A
18
Q

The generated current in ultrasonic energy systems create ultrasonic waves at how many vibrations per second?

A

55,500

19
Q

What vessel size can a harmonic device reliably seal?

A

Up to 3mm

20
Q

What is the collateral thermal damage with use of a harmonic device?

A

0-1 mm in a porcine model

21
Q

Were bursting pressures shown to be higher in LigaSure or Enseal in one study?

A

Enseal

22
Q

What determines the power density of a laser?

A

PD = power(watts)/spot size area(cm2)

23
Q

What is the focal length of a laser?

A

The distance from the aperture to the laser’s highest power intensity (typically 1-3 mm)

24
Q

What are the four basic interactions of a laser beam with tissue?

A
  1. Absorption (most important for laser tissue interactions)
  2. Transmission
  3. Scatter
  4. Reflection
25
Q

Describe the various tissue penetrations of commonly used lasers based on wavelength.

A
26
Q

What are the zones of injury based on proximity to the laser energy source?

A
  1. Zone of carbonization
  2. Zone of coagulation
  3. Zone of hyperthermia
27
Q

What is the approximate tissue penetration of the Nd:YAG laser?

A

5mm

28
Q

What size vessel can be sealed using a CO2 laser?

A

<0.6mm

29
Q
A

Surgical biology and methods (11 decks)

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