It has been reported that at least 80% of all surgical procedures performed involve electrosurgery units (ESUs). The Bovie Electrosurgery Generator is used to cut or coagulate tissue using electrical current at varying voltages and currents. As with any invasive procedure, proper training in safety methods is mandatory for avoiding injuries to either the patients or the surgical team.
Unfamiliarity with the potential dangers inherent in using electrosurgical techniques can increase the chances of harm. In risk assessment, staff needs to identify the hazards and patients who are potentially in danger. Once determined, the procedures can be analyzed objectively. Using evidence based research, it is possible to decide if the benefits outweigh the possible liabilities.
It has been reported that simple desiccation using an ESU poses minimal risk to an otherwise healthy pacemaker patient, especially when attention is paid to patient history, proper grounding and attentive monitoring. On the other hand, they recommended to avoid the use of cutting current for these patients. The electrosurgery generator can interfere with the effect of electromedical devices, either causing it to enter an asynchronous mode or to block its effect on the patient’s body altogether.
Monopolar electrosurgery passes current through most of the patient’s body, to the plate located elsewhere. Because the current density rapidly decreases, it only creates an incision or coagulates at the surgical site. Bipolar electrosurgery is considered safer for patients with pacemakers in situ. This technique uses a pair of forceps-like electrodes to pass current from one point to another point via a direct pathway.
Following the recommendations given by the manufacturer of the pacemaker is critical for patient safety. The dispersive electrode should be applied closely to the surgical site, but distal to the site of the pacemaker. The ESU should not be activated at a rate similar to the patient’s heart rate. Additionally, the patient’s ECG should be monitored at all times.
Surgical staff should have a thorough understanding of electrosurgical safety before assisting in procedures using these methods. While being familiar with the implications for patients with pacemakers is critical, having a broader knowledge of how the equipment works is essential for the surgical team.
Electrosurgery is a fundamental surgical technique. With proper training in electrosurgical safety techniques, the benefits to patients outweigh possible risks. The Bovie Electrosurgery Generator is a useful tool for making incisions, for coagulation and to treat benign and malignant skin lesions.