Electrosurgery is the application of electricity for thermal destruction of tissue through coagulation, dehydration or vaporization. Electrosurgery works on the principal of electric current created through movement of electrons due to voltage. Electrosurgical units used for performing electrosurgery converts standard frequency of 50 to 60 Hz to higher frequencies of 3,00,000 to 5,00,000 Hz.
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Three types of electrosurgeries are majorly used, which are as follows:
- High-frequency electrosurgery: High-frequency electrosurgery is composed of four different techniques including electrocoagulation, electrofulguration, electrodessication and electrosection. High frequency alternating current is used in these methods which get converted to heat due to resistance as it travels through the tissue. This heat buildup inside the tissue results in thermal tissue damage. These techniques are commonly used for the treatment of hemostasis, rhinophyma excision, malignant skin conditions such as acrochordons, basal cell carcinoma.
- Electrocautery: Electrocautery involves direct transfer of heat to tissue instead of alternating current. In this technique, a handheld element is heated through electric current, which is then directly applied to the tissue leading to thermal destruction of that tissue. Electrocautery is majorly used for hemostasis and tumor destruction.
- Electrolysis: Electrolysis uses chemical reaction created with the help of direct current to damage tissue. As for example cobalation, an aesthetic technique used for facial rejuvenation uses an electric current for ionizing a conduction medium to transmit heat to the tissue. Isotonic saline is majorly used as conduction medium.
Electrosurgery plays an important role in different types of surgeries which include:
- Gynecology surgery
- Urologic surgery
- Cosmetic surgery
- Orthopedic surgery
- Cardiovascular surgery
It is not advisable to perform electrosurgery on anatomical locations of concern including areas near the eye or any site with narrow stalk or base such as finger, scrotum, papilloma because application of current on these sites can result in channeling or ocular injury. Patients implanted with electronic devices such as cardiac and gastric pacemakers, cochlear implants, ICDs are also not suitable for electrosurgery as it can lead to fatal adverse effects.
Electrosurgical unit consist of various types of products, these products are divided into three major segments namely electrosurgical generators, electrosurgical instruments, argon and smoke management system. The electrosurgical instruments are further divided into monopolar and bipolar instruments. Monopolar instruments include electrodes, electrosurgical pencils, suction coagulators and monopolar forceps while bipolar instruments include advanced vessel sealing instruments and bipolar forceps. Accessories which are utilized with electrosurgical instruments include cords, patient return electrodes, adapters, cables, foot switches, tip cleaners and carts.
Market for electrosurgery and electrosurgical units are increasing continuously by development of advanced energy based electrosurgical devices, increasing demand of the surgical procedures, rise in aging population. Continuous innovation in the field is leading to the growth in demand for electrosurgery and electrosurgical units as the improved products protect the surrounding tissue from thermal damage and limits sticking of tissues.
North America dominates the electrosurgery market followed by Europe due to prevalence of hemostasis in the region. While Asia-Pacific is currently at growth stage and is expected to grow at faster pace due to emerging economies of India, China, Japan and Malaysia.
Government and corporate involvement for improving healthcare sector and growing popularity of cosmetic surgery are also stimulating the growth of electrosurgery market in Asia-Pacific. Key players in the market include B.Braun Melsungen AG, BOWA-electronic GmbH Co. KG, Covidien plc, KLC Martin Group, Utah Medical Products, Inc., Olympus Corporation and CONMED Corporation.
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