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In this video Dr. Jänes will show some tips and tricks on avoiding accidents during surgery.
Monopolar electrosurgery involves the use of a return electrode as a resistor. A current goes through the patients to come back to the generator. The current from the patient to the pad can cause the pad to become warm. If it is poorly affixed to the patient, it will increase the current and cause increased heat buildup. Dr. Jänes points out the potential risks of monopolar electrosurgery.
When there are adhesions that you want to take down, resistance increases, electrons take another path and concentrate in a small bridge near to a vital organ causing necrosis. If you do not control your instrument, it can be damaged by repeated sterilization, electrical heating or even a manufacturing defect.
When it comes to ultrasonic technology, the construction of the blade determines how it should be used. As the blade vibrates, the displacement is greater at the distal part of the blade, which is why there are more distal cuts. The power setting is also important, as it specifies the current delivered by the generator, which determines blade displacement. The ultrasonic instruments are important because they are multifunctional tools, with five main factors impacting cut and coagulation: power level, tissue tension, blade pressure, blade sharpness and blade location.
Finally, Dr. Jänes concludes that monopolar devices are the best for heat, bipolar for time, and advanced bipolar for compression.
