What Is Electrosurgery and How an ESU Works | DS.Med
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What Is Electrosurgery and How an ESU Works

Electrosurgery · DS.Med editorial

An electrosurgical unit (ESU) passes high-frequency current (400–500 kHz) through tissue. At this frequency current does not stimulate nerves and muscles — instead its energy heats cells so fast they vaporize (cutting) or dry out slowly (coagulation). One generator replaces the scalpel and the ligature at once.

Monopolar and bipolar circuits

In monopolar mode current flows from the active electrode through the body to a return plate — powerful and universal, from skin incisions to deep dissection. In bipolar mode current passes only between the tips of the forceps: minimal spread, precise coagulation of fine structures, no return plate needed.

Cutting, blend, coagulation

  • Clean cut — continuous sine wave: smooth incision, minimal thermal margin
  • Blend 1–3 — interrupted waveform: the cut coagulates its own edges, less bleeding
  • Contact coagulation — the electrode touches the vessel and seals it
  • Spray coagulation — sparks scatter over an oozing surface without contact

Modern units add specialized algorithms: bipolar autostart, intelligent polypectomy, vessel sealing (Seal) and TURP modes for work in liquid medium — the ESU becomes a platform covering every surgical specialty.

Frequently asked questions

Is electrosurgery safe for the patient?
Yes — at 400–500 kHz current does not trigger nerves or the heart; safety systems monitor the return electrode and tissue impedance continuously.
What is the difference between cutting and coagulation current?
Cutting uses a continuous waveform that vaporizes cells; coagulation uses short bursts that heat tissue slowly, drying and sealing it.
When is bipolar mode preferred?
On fine structures, near nerves, in patients with implants and wherever current spread through the body must be avoided.
Related equipment: DS.Surg ESU line Radio wave units

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