What Happens During Electrosurgery?
First, you'll get anesthesia so you don't feel pain. During the procedure, an electrosurgical unit (ESU) will power a current and send it to an electrode. What happens next depends on the method.
Monopolar electrosurgery
Most electrosurgery is monopolar. This means that only one ("mono") electrode tip comes into contact with your body.
- The ESU sends the current to an active electrode.
- The current from the electrode passes through tissue, heating it.
- The current travels to a electrosurgical pad (dispersive electrode). It may be a grounding pad on your thigh or a plate you hold onto.
- The current travels from the dispersive electrode back to the ESU.
Bipolar electrosurgery
With bipolar electrosurgery, two ("bi") electrode tips touch your body. For example, your provider may use forceps to clasp the tissue being treated. One side contains the active electrode. The other side contains the return electrode.
- The ESU sends the current to the active electrode.
- The current from the electrode passes through the tissue to the return electrode.
- The current travels from the return electrode back to the ESU, completing the circuit.
Risks / Benefits
What are the potential benefits of electrosurgery?
Electrosurgery can remove atypical tissue without physical cuts from a scalpel. It allows healthcare providers to:
Target the treatment area with little damage to surrounding tissue
Remove tissue with little scarring
Ablate (destroy) tissue quickly
Stop bleeding fast
Electrosurgery and curettage cure basal cell carcinomas and squamous cell carcinomas 90% to 95% of the time.
What are the risks of electrosurgery?
Electrosurgery is safe, especially when you're working with a healthcare provider who performs it regularly. As with any procedure, though, there are risks. Risks of electrosurgery include:
Burns. Too much heat from the current can cause burns. Providers prevent this by ensuring that the ESU settings are correct. They start with the lowest possible power settings that also get the job done. The design of the return pad can also effectively reduce the risk of burns; for example, some return pads are designed so that the gel layer completely covers the metal layer, while some return electrodes prevent burns by using large areas and specially shaped designs to disperse the current.
Electric shock. There's a risk of shock if the electricity isn't grounded correctly. Your healthcare provider will take care that the setup is correct to prevent this from happening.
Infections. A contaminated electrode can spread germs. Also, the smoke from electrosurgery can spread toxins and germs. Your provider can keep you safe by using sanitized electrodes. They'll perform the procedure in a room with a smoke ventilation system.
Bleeding. Tissue damage sometimes leads to excessive bleeding. Your provider will adjust the ESU settings to reduce the chances of this happening.
Skin changes. Some types of electrosurgery can lighten your skin tone at the treatment site (hypopigmentation). Your provider will let you know if this is a risk based on your procedure.
Problems with implants. Some types of electrosurgery can interfere with the electrical signals in pacemakers and defibrillators. Your provider will ensure electrosurgery doesn't interfere with these devices.