Electrosurgery

Since the electrosurgical instruments are commonly used in a wide variety of surgical specialties, understanding of the properties of these instruments is very important to prevent the potential complications. We report the case of a patient who sustained a third-degree dermal burn caused by contact with the ground plate of the electrosurgical system. This burn healed with surgical treatment. Since electrosurgery causes serious complications, surgeon and operating suite personnel should pay attention to the electrosurgical system during the operation. Additionally, patients must be informed about these complications.

The role of prosthetic restorations in the final appearance of the surrounding soft tissues has long been recognized. Innovative prosthodontic concepts as described should be used to enhance the biologic as well as the esthetic data of the supporting tissues, in natural teeth and implants alike. Combined dental treatment modalities of different kinds (i.e., orthodontics, periodontal treatment) are often required for optimal results. Meticulous care and attention to the delicate soft tissues should be given throughout all phases of the treatment, with a view to achieving a functional, healthy, and esthetic oral environment.

The purpose of this study was to compare pulpal and periapical tissue reactions to electrosurgery versus formocresol pulpotomy techniques in the primary teeth of dogs. The study was conducted on 33 primary teeth of three mongrel dogs between the ages of one to three months. Each dog had three teeth treated by Formocresol Pulpotomy with Mechanical Coronal Pulp Removal (FC), three teeth treated by Electrosurgery Pulpotomy with Mechanical Coronal Pulp Removal (ES/MCPR), three teeth treated by Electrosurgery Pulpotomy with Electrosurgical Coronal Pulp Removal (ES/ECPR), and two teeth serving as untreated Controls. Dogs one, two and three were sacrificed performing the pulpotomies at two, four and six weeks, respectively. The pulp, periapical tissue and after surrounding bone were submitted to histological examination and the histological reaction was recorded. The results were fourteen out of 18 unfavorable and zero out of three favorable histological reactions occurred in the FC treate...

Perioral rhytides affect more than 90% of women, the impact of these problems on the patient's self-esteem can become important enough to affect quality of life in psychological and sociocultural terms. Basic science shows that skin rhytides are related to loss in quantity and function of dermal collagen fibers. An electrosurgical technology was used in this study for treatment of perioral rhytides. The authors treated 34 patients (26 women and 8 men) for perioral rhytides with voltaic arc dermabrasion technique. Patient ages ranged between 30 and 65 years and the majority (90%) of these perioral areas had class II and III wrinkle scores. Voltaic arc dermabrasion was used to remove the keratinized layer for point perioral area. Treatments are minimally painful and in the authors' experience require no anesthesia. No discomfort should be expected once the voltaic arc dermabrasion treatment is concluded. The perioral dermis appears as a pale, erythematous, dull surface. Bleeding is not seen unless excessive abrading occurs with the saline-moistened gauze. No hyperpigmentation, hypopigmentation, erythema, ecchymosis, pain, itching, outbreaks of herpes, infectious processes, and scarring were observed. All patients monitored for fine perioral rhytides showed a reduction in the treated area. Since skin-specific quality of life was significantly improved after ''vol-taic arc'' treatment, this therapy can be recommended for patients with perioral rhytides skin wishing to improve their appearance.

Study Type – Therapy (RCT) Level of Evidence 1bStudy Type – Therapy (RCT) Level of Evidence 1bOBJECTIVETo evaluate the efficiency, safety and short-term outcome of transurethral resection in saline plasma vaporization of the prostate (TURis-PVP), and to compare it to the standard TUR of the prostate (TURP).To evaluate the efficiency, safety and short-term outcome of transurethral resection in saline plasma vaporization of the prostate (TURis-PVP), and to compare it to the standard TUR of the prostate (TURP).PATIENTS AND METHODSIn all, 155 patients with benign prostatic enlargement (BPE) secondary to benign prostatic hyperplasia (BPH), with a maximum urinary flow rate (Qmax) of <10 mL/s, an International Prostate Symptom Score (IPSS) of >19 and prostate volume of 30–80 mL were enrolled in this prospective, randomized trial. All patients were evaluated preoperatively and at 1, 3 and 6 months after surgery by IPSS, health-related quality of life (HRQL) score, Qmax and postvoid residual urine volume (PVR).In all, 155 patients with benign prostatic enlargement (BPE) secondary to benign prostatic hyperplasia (BPH), with a maximum urinary flow rate (Qmax) of <10 mL/s, an International Prostate Symptom Score (IPSS) of >19 and prostate volume of 30–80 mL were enrolled in this prospective, randomized trial. All patients were evaluated preoperatively and at 1, 3 and 6 months after surgery by IPSS, health-related quality of life (HRQL) score, Qmax and postvoid residual urine volume (PVR).RESULTSPatients from both series had similar preoperative characteristics. TURis-PVP and TURP were successfully performed in all cases (75 and 80, respectively). The operative duration, catheterization period and hospital stay were significantly shorter for TURis-PVP patients at 35.1 vs 50.4 min, 23.8 vs 71.2 and 47.6 vs 93.1 h, respectively (all P < 0.05). At the 1, 3 and 6 months follow-ups, improvements in the variables measured were better in the TURis-PVP group: the IPSS was 4.4 vs 8.3 and the Qmax was 22.7 vs 20.5 mL/s at 1 month; the IPSS was 4.8 vs 8.6 and the Qmax was 22.3 vs 20.0 mL/s at 3 months; and the IPSS was 5 vs 9.1 and the Qmax was 21.8 vs 19.3 mL/s at 6 months (All P < 0.05).Patients from both series had similar preoperative characteristics. TURis-PVP and TURP were successfully performed in all cases (75 and 80, respectively). The operative duration, catheterization period and hospital stay were significantly shorter for TURis-PVP patients at 35.1 vs 50.4 min, 23.8 vs 71.2 and 47.6 vs 93.1 h, respectively (all P < 0.05). At the 1, 3 and 6 months follow-ups, improvements in the variables measured were better in the TURis-PVP group: the IPSS was 4.4 vs 8.3 and the Qmax was 22.7 vs 20.5 mL/s at 1 month; the IPSS was 4.8 vs 8.6 and the Qmax was 22.3 vs 20.0 mL/s at 3 months; and the IPSS was 5 vs 9.1 and the Qmax was 21.8 vs 19.3 mL/s at 6 months (All P < 0.05).CONCLUSIONSTURis-PVP represents a valuable endoscopic treatment alternative for patients with BPE, with superior efficacy, short-term results and complication rates compared with monopolar TURP.TURis-PVP represents a valuable endoscopic treatment alternative for patients with BPE, with superior efficacy, short-term results and complication rates compared with monopolar TURP.

The biophysics, mechanism of actions, applications, benefits and complications of electromagnetic (EM) energy-based surgical instruments, and their current use are reviewed. Understanding the mechanism of action, tissue effects, and appropriate applications of EM devices is critical to achieving an optimal surgical outcome. Although a more diverse range of EM devices are used in human medicine, current use in veterinary medicine is limited to conventional electrosurgery and CO(2) lasers.

Transurethral electrovaporization of the prostate is a new, minimally invasive technique being used by urologists for surgical ablation of prostatic tissue. There are insufficient data concerning factors affecting the vaporization and coagulation lesions produced by this technique. The aim of this study was to determine the role of various parameters for adequate tissue evaporation. This study compared bovine liver and human prostatic lesions made by the Vaportrode instrument with those produced by standard electrocautery loops, roller balls, and laser fibers. Additionally, two electrosurgical instruments with differing technical capabilities were compared for their ability to cause vaporization of tissue. Results revealed that the Vaportrode lesions were maximal with a new electrode when used with a Force 40S electrosurgical generator set at 300 W and a drag speed of 25 to 30 seconds per 10 mm of tissue. The lesions produced by this technique had a 74% greater coagulation volume compared to a standard cautery loop. The evaporation defect was comparable to a laser lesion produced in contact at 60 W. We conclude that electrovaporization under optimal conditions causes a vaporization lesion comparable to that produced by high power density laser prostatectomy. Additionally, the coagulation volume of a vaportrode lesion is considerably greater than that produced by standard electrocautery resection.

INTRODUCTION:
It has been estimated that 58% of people over 40 years of age have haemorrhoidal disease to some extent. Indications for operative treatment include third and fourth degree prolapsing haemorrhoids. Haemorrhoidectomy is frequently associated with significant postoperative pain and new techniques to reduce this pain are constantly under evaluation. The present study was conducted to determine the usefulness of the Ligasure system and compare it with conventional diathermy for haemorrhoidectomy.
METHODS:
25 patients with grade 3 or 4 haemorrhoids requiring surgery were recruited and submitted to Ligasure Haemorrhoidectomy. They were compared with 25 patients operated with Milligan Morgan technique with diathermy. All patients were operated by the same two surgeons, who collaborate each other.
RESULTS:
There were no statistical differences in age, gender or clinical symptoms between the two groups. The mean operating time was 21.1 minutes (range, 15-32 min) in the Study Group and 19.8 min (range, 15-28 min) in the Control Group. Patients were dismissed the same day or the following day after surgery, without statistical differences. Early complications were similar, mainly represented by urinary retention, while late complications were comparable (1 bleeding in each group and 2 late healing in the Control Group). A partial reduction in postoperative pain and a faster healing of postoperative scars were observed in the Study Group.
CONCLUSIONS:
Ligasure Haemorrhoidectomy is a safe procedure in the treatment of 3rd and 4th grade haemorrhoids. In our study we observed a reduction of postoperative oedema and a faster healing of surgical scars, without affecting postoperative complications.

The aim of our study was to evaluate the therapeutic effectiveness of loop electrosurgical excision procedure (LEEP) in Greek patients with vulvar intraepithelial neoplasia (VIN). Between January 2002 and January 2009, 55 women with histologically confirmed VIN usual type were included in our study. For the LEEP procedure we used a high frequency electrosurgical unit with at least 80 W output. The tissue was removed to the second surgical plane. Statistical analyses were performed using the SPSS-13 for Windows. Complete response rate at 12-month follow-up was 100%. Complete response rate at 48 months of follow-up was 80%. Recurrence rate at 48 months of follow-up was 20%. LEEP may constitute a valuable excisional method for the treatment of VIN. It provides an interpretable specimen of the whole lesion within a few minutes. It needs a short period of training and has low cost.

The aim of this study was to compare the clinical and radiographic success rates of electrosurgical pulpotomy of human primary molars with zinc oxide eugenol (ZOE) and zinc polycarboxylate (ZPC) cements. In this randomized clinical trial study, 120 primary second molar teeth were treated by electrosurgical pulpotomy. Teeth were randomly assigned to two groups according to whether ZOE or ZPC cement was used as a sub-base. Teeth were restored with stainless steel crowns and were evaluated clinically and radiographically after 3, 6, and 12 months by two independent examiners. Clinical treatment outcomes and radiographic findings were statistically analyzed using Fishers&#39; exact test with statistically significant differences defined for P &lt; 0.05. At 12 months, the clinical and radiographic success rates in the ZOE group were 98.2% and 84.2% and in the ZPC group were 96.2% and 75%, respectively (P &gt; 0.05 for all). The outcomes of this study suggested that either ZPC or ZOE sub-...

The recent appearance of lasers has made electrosurgical methods almost obsolete. They seem to be routinely avoided by both dermatologists and their patients. In this paper, the benefits of electrosurgery are emphasized, pointing out that these are easy to master, efficient and low-cost procedures. An overview of the five types of cutaneous electrosurgery (electrodesiccation, electrofulguration, electrocoagulation/electrocutting, electrocautery, and electrolysis) is provided. Special attention is given to the use of electrosurgery in patients with electromedical implants. When performed with care, electrosurgery remains a safe, efficient and low-cost treatment option.