Electrosurgery in Operative Endoscopy

Electrosurgery has been one of the principle procedures in operative endoscopy for some twenty years. However, partly due to fears about complications, particulary burns, and partly through the emergence of laser surgery, these techniques have been going through a phase of unpopularity. The main causes of complications have been removed, through the development of new generators, with inbuilt microprocessors and excellent safety features. Monopolar electrosurgery can provide precise cutting, with little tissue damage, rivalling the most precise laser, and its coagulation capabilities are far superior to most modern lasers. This handbook necessarily combines principles and practice because safe clinical applications can only be properly employed and complications avoided if their theorectical basis is properly understood. This applies both to the underlying theorectical physics and current generators. Section II explains the salient features of monopolar and bipolar surgery, principles of generator circuitry and ESG effects. The dispersive electrode gets its own section because about 70% of complications at monopolar surgery are caused by it. Operative endoscopy is evolving rapidly, and Section IV gives a full account of laparoscopy and endoscopic applications of electrosurgery.