高频电刀的使用和注意事项.pptVIP

* Many electrosurgical units have two modes of functioning: monopolar (also called unipolar) and bipolar. This slide shows a monopolar circuit. In the monopolar mode, only the active electrode is in the operative wound. The return electrode is placed at some other location on the patient’s body. Current flows through the patient’s body, between the active electrode and the return electrode. Monopolar electrosurgery is used for tissue cutting, fulguration, and desiccation. Monopolar electrosurgery uses high voltage with voltage between 3000 volts and 9000 volts in coag and 1350 volts and 4000 volts in cut. * With the bipolar mode there are still two electrodes, an active and a return electrode. They are both incorporated into the same instrument. In this example, the current flows between the tips (simplistically, one is the active and the other is the return) of the bipolar forceps that are grasping tissue. Because the current flows from one tip (electrode), through tissue, to the other tip (electrode) the circuit is completed without current traveling through any other part of the patient’s body. A return electrode (pad) is not needed for a bipolar procedure. The tissue effect of bipolar electrosurgery, when forceps are used, is desiccation, because the tines of the forceps are in direct contact with the tissue. Other instrumentation is available that allows cutting during bipolar procedures. A benefit of bipolar electrosurgery is the use of lower voltage to push the current through the tissue. Because the forceps grasp only a small amount of tissue, the resistance is low. Consequently, the amount of voltage required will be low. * Prior to generator use, set the activation tone to an audible level and test the alarm systems to ensure that the tones can be heard. All alarms should be tested to assure the ESU is functioning appropriately. The activation tone alerts the surgical team when the generator is delivering RF energy. (1) When plugging ac