ENTC 4350. ELECTROSURGICAL UNITS (ESUs). General Surgery. The electrosurgical unit (ESU) is generally used in surgery.
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To cut tissue, the switch is usually set to the cut position
This connects the RF voltage to the amplifier, which then delivers to the active electrode 1,000 to 8,000 volts peak-to-peak AC at from 100 kHz to about 2 megahertz. High-density currents emerge from the active electrode to do the cutting.
In this case, cutting would occur about one fourth of the time; and the rest of the time, the heat generated would propagate into the tissue, creating a layer of coagulum along the incision to control bleeding.
The degree of coagulation can be monitored by observing the browning of the tissue.
The surgeon has control of the cutting and coagulation by the stroke he or she uses.
One surgeon may prefer to use a coag-blend mode throughout the procedure and control the cutting and coagulation by the force exerted on the blade, the depth of the blade in the tissue, and the duration of contact.
The use of the ESU is a refined surgical skill, developed by practice.