Demystifying
Electrosurgery
for the
Veterinarian
Practice
eBook
INTRODUCTION
Electrosurgery is becoming a more prevalent
application within Veterinary medicine.
Veterinarians are utilizing electrosurgery in
common procedures such as Spay, Neuter,
Onychectomy, Gingivectomy and various simple
skin procedures. For those not familiar with
electrosurgery, it may be intimidating, several
questions crop up. What are the differences
between the various electrosurgical generators?
When should I use electrosurgery versus
radiosurgery versus cautery? Is it safe? In this
eBook, by Bovie, we will address these concerns
to demystify the myths and solidify your
confidence when utilizing electrosurgery in your
veterinary practice.
Demystifying Electrosurgery for the Veterinarian Practice
2
Table of Contents
4
5
Electrosurgery: An
Overview
Electrosurgery versus
Cautery
6
7
Electrosurgery
versus Radiosurgery/
Radiofrequency
Purchasing an
Electrosurgical Device:
Key Questions to Ask
8
9
Electrosurgical Safety
Considerations
Conclusion
9
About Bovie Medical
Demystifying Electrosurgery for the Veterinarian Practice
3
Electrosurgery: An Overview
Electrosurgery is the application of delivering
energy to stop bleeding and eradicate tissue.
Energy is delivered in two ways; using monopolar
electrosurgery or bipolar electrosurgery. In
monopolar electrosurgery tissue is cut and
coagulated by completing an electrical circuit that
includes the components within an electrosurgical
generator (ESU), the patient plate (also referred
to as the dispersive electrode or return electrode),
the connecting cable and the active electrodes
(normally within an electrosurgical pencil). In
most applications electric current from the ESU
is conducted through the surgical site with an
active cable and electrode. The electrosurgical
current is then dispersed through the patient, to
the patient plate (return electrode), returning the
energy to the generator to complete the path.
The monopolar or bipolar energy output
is engineered into specialize waveforms to
provide a variety of effects during a surgical
procedure. The most common waveforms (or
modalities) include; Cut, Blend, Coagulation,
Fulguration and Bipolar. In the clinical setting,
these various modalities are used in conjunction
with specialized electrode tips, for a variety of
applications and tissue effects.
In bipolar electrosurgery, two electrodes
(generally the tips of a pair of forceps or scissors)
serve as the equivalent of the active electrode
and return electrode (or patient plate) utilized
in monopolar mode. Bipolar electrosurgery does
not require a patient plate. The electrosurgical
current in the patient is restricted to a small
volume of tissue in the immediate region
between the forceps. This affords greater control
over the area to be coagulated.
Demystifying Electrosurgery for the Veterinarian Practice
4
Electrosurgery versus Cautery
The terms electrosurgery and cautery are often
used interchangeably, because they can cause
similar tissue effects. Many people mistakenly
think that they are the same thing. They are
not. Bovie Medical manufactures both device
types and they can both be used to reduce or
stop bleeding, that is where the similarity ends.
Cautery uses a heated wire tip to physically heat
the tissue causing the small blood vessels to seal
off and stop the bleeding. The cautery devices
are used strictly for coagulation, with no cut
capability, and for superficial tissue removal.
Electrosurgery, sometimes referred to as
electrocautery, is a stream of electrons delivered
using an electrode tip to excite the water
molecules in the tissue cells causing a vaporization
or charring of the target tissue.
Demystifying Electrosurgery for the Veterinarian Practice
5
Electrosurgery versus Radiosurgery/Radiofrequency
There is a great misconception regarding
electrosurgery and radiosurgery or
radiofrequency (RF). Radiosurgery generators
have been marketed, by some manufacturers,
to cause minimal tissue damage, because
they operate at a higher frequency. And
therefore, promote better healing over general
electrosurgery. This is a stretch of the truth.
All electrosurgical devices are radiofrequency
devices. All of these devices use RF electricity to
heat tissue. The depth of tissue damage is not a
function of frequency, there are many variables
involved; power output, duration of application,
tissue physiology and other more technical
variables. Beware of these expensive marketing
tactics; the fundamental operating principles of
all electrosurgical devices are identical.1
Demystifying Electrosurgery for the Veterinarian Practice
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Purchasing an Electrosurgical Device: Key Questions to Ask
Since all RF devices are fundamentally the
same, what variables should be taken into
account when making a buying decision? Here
are a couple questions that a veterinary clinic
should consider when determining what unit is
appropriate for the facility.
• Does the facility require electrosurgical
cutting capability? If the answer is no, then
the buying decision is pretty simple. The
facility requires a low watt High Frequency
Desiccator like the Aaron® 940, by Bovie.
• What types of animals does the veterinary
facility serve? The larger the animal, the
higher the tissue impedance. The higher
the tissue impedance the more power your
facility will require. The primary difference
between electrosurgical generators is
power.
• What procedures will be performed using
the device? Understanding your procedural
needs will help your manufacturer
representative pair you with the
electrosurgical generator with the features
you will actually use.
Demystifying Electrosurgery for the Veterinarian Practice
• What procedure would you like to perform
in the future? Consider your facilities
strategic goals; are they planning to
expand, hire more staff, increase procedural
offering? When purchasing capital
equipment, the facilities goals should
always be addressed.
• How often will the electrosurgical generator
be used? For all veterinary facilities, time
is money. Understanding the features and
benefits of the individual generators (Bovie
offers 6 different models) will save the
facility time and maximize their return on
investment.
• What is the facilities equipment budget? As
stated before, beware of these expensive
marketing tactics; the fundamental
operating principles of all electrosurgical
devices are the same. Don’t pay more for a
good story.
7
Electrosurgical Safety Considerations
The modern electrosurgery generator is designed
to be safe. As with any complex surgical device,
there are necessary precautions when utilizing
an electrosurgical device. User error is a common
occurrence with any new device. Prior to use, staff
responsible for the operation of the ESU should
read the user manual for full instruction on
safety and precautions. Some manufacturers, like
Bovie Medical Corporation, offer manufacturer
representatives who will train the entire
veterinary staff on the setup and operation of
new device. This service is at no additional cost to
the facility.
Common hazards associated with the use of
electrosurgical devices include fire/explosion,
patient burn and the potential inhalation of
noxious surgical smoke. Although most fire
hazards have been greatly reduced over the
years, without proper precautions it can occur.
Explosions and fire can occur if electrical sparks
ignite flammable gases or solutions. Inadvertent
activation of an active electrode positioned
on sponges, drapes or in an oxygen-enriched
environment can result in a fire.
Unintended patient burns are often caused due
to incorrect patient plate placement. When
grounding the patient, it is important to follow
the instructions provided with the grounding
Demystifying Electrosurgery for the Veterinarian Practice
plate. The preparation of the pad placement site
is equally as critical to the actual placement of the
pad.
Surgical smoke is a general term and may
sometimes be presented as “plume”, “aerosol”,
or “vapour”. Surgical smoke is created by a
variety of heat producing devices used in surgical
procedures, including electrosurgery, lasers and
harmonic scalpels and can carry with it smoke
plume hazards. The plumes are, at minimum, an
annoyance and may cause impaired visualization
of the surgical site for the surgeon. However,
surgical plume may pose serious health hazards to
the patient, veterinarian and staff. It is estimated
that over 500,000 persons are exposed to surgical
smoke each year.2 Implementing a smoke
evacuation system, such as the Bovie Smoke
Shark™ II Smoke Evacuator, significantly reduces
the risk of surgical smoke exposure.
Although the above safety hazards exist, and
are all inherent to the use of electrosurgery,
they are all controllable hazards. Following
all safety precaution in the instruction for use,
proper smoke evacuation and developing a
strong relationship with your manufacturer
representative for continued training will assure
a safe environment for both the patient and
veterinary staff.
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Conclusion
Electrosurgery is proven to be a safe and effective technology for veterinary use. Understanding
the basic principles of operation will alleviate any reservations when purchasing or operating an
electrosurgical device. For more information, contact your Bovie representative.
About Bovie Medical
Bovie Medical is setting the standard for veterinarian specific electrosurgical generators and accessories
with a range of “state of the art” models: the Aaron 940-V, the Aaron 950-V, the Aaron 1250-V, the
Aaron 2250, and the Aaron 3250. This full line is the most complete offering of any USA manufactured
electrosurgical generator product. The feature-packed generators are designed from the ground up to
be extremely reliable, and are US and Canadian Standards compliant.
Over the past decade, we have expanded our manufacturing capabilities to include a full line of
disposable electrosurgical electrodes in blade, ball, needle, loop and laparoscopic form. The reusable ES
pencils, with a full compliment of reusable electrodes and bi-polar forceps, enhance our ever-expanding
line of products.
In addition to electrosurgery, Bovie Medical is the number-one producer of battery-operated cauteries in
the world. Its product lines, distribution channels, and renowned industry reputation continue to grow.
The company also manufactures a line of replaceable battery and tip cauteries, known as Change-ATip™. We manufacture a variety of specialty products, such as nerve locators, lighted stylets, and corneal
rust ring removers, the bulk of which follow the battery operated, tubular manufacturing process.
Bovie Medical continues to improve and expand its product offerings and services, as well as continuing
its excellent record of support to existing customers.
Contact Us:
Bovie Medical Corporation
5115 Ulmerton Road
Clearwater, FL 33760
800.537.2790
www.boviemed.com
Demystifying Electrosurgery for the Veterinarian Practice
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References
(1) Zinder, M.D., Daniel J. Common myths of electrosurgery, Otolaryngology – Head and Neck Surgery 2000
(2) Bovie Medical Corporation, Addressing Surgical Smoke in the Operating Room, 2013
(3) McCauley, Genard, Understanding Electrosurgery, 2010
Demystifying Electrosurgery for the Veterinarian Practice
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