The Colloquium 6 (2017) pp.11-14

* Corresponding author:

alii.alzedi@gmail.com

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POST GRADUATE STUDENT SOCIETYSCHOOL OF GRADUATE STUDIES

Research Trends in Generator of Electrosurgical System Ali Idham Alzaidi1*, Azli Bin Yahya2, Tan Tim1, Norhalima Idris3

1 Faculty of Biomedical Engineering, Universiti Teknologi Malaysia, 81310 UTM Skudai, Johor, Malaysia. 2 Faculty of Electrical Engineering, Universiti Teknologi Malaysia, 81310 UTM Skudai, Johor, Malaysia. 3 Faculty of Management, Universiti Teknologi Malaysia, 81310 UTM Skudai, Johor, Malaysia. KEYWORDS ABSTRACT ESU Bipolar Monopolar Dielectric Generator Tissue response.

There are different sorts of surgery, which can be delivered utilizing high recurrence instruments, for example, diathermy, bipolar and Monopolar. This paper presents various type of generators for electro surgery system incline in a wide range of the hi-frequency surgery instruments, such as, diathermy, bipolar, monopolar and the tissue reaction generator in the execution of ESU. Within the previous three decades, a dramatic increase in surgery has been an incredible intervention and microvascular surgery has provoked the most noteworthy use of radio frequency instruments. Electrosurgery, which can likewise be called as radiosurgery, has been utilized as a part of various types of surgery for more than 100years.

1. Introduction

While heat generation occurs within the tissue, the treatment electrode acts as a conductor that only passes the current and may remain cooler than the treated medium [1, 2]. Electrocautery differs from electrosurgery in that an electrical current heats a metallic probe that is then applied to tissue (hot iron cautery) [3]. Electrosurgery (ES) has been characterized as the deliberate entry of high-frequency waveforms, or streams, through the tissues of the body to accomplish a controllable surgical effect [4]. However, the audit introduced in this paper is on flow ESU investigate patterns completed by analysts on sorts, procedures, and impact on the human body tissue [5]. The territories are chosen because of the novel methods utilized (Bipolar, monopolar and diathermy) the natural part of (Terminals impact on the cell) and exertion towards approving and anticipating ESU execution (demonstrating technique) [2]. 2. Principles of electrosurgery

Expert and specialist ought to have the learning of major and rule of electrosurgical [1]. ESU machine is an alternating current source that operates at radio frequency “RF” as show in fig 1 the spectrum frequency of ESU.The main rules the should know as :

• A high frequency current flowing through active electrode “high current concentration”.

• Cell ruptured-fumes or evaporates. • Return path through dispersive

electrode “low current and heat dissipates”.

• Patient is included in circuit. • Current concentration or density

depends on the size of the area through which the current flows.

• HF generation can be activated by a foot switch or finger switch on the surgical handle.

Figure 1: Spectrum Frequency of ESU [3].

3. High Energy Surgical Instruments

Heating and vaporization of tissue, allows these units to be used safely in a wide variety of circumstances. The relative advantages of electrosurgery versus laser have been confused in recent years particularly for laparoscopic use though it is true that electrosurgery is less expensive, easier to use and provides better hemostasis than laser [5].

3.1. Bipolar Electrosurgical Devices

Bipolar electrosurgical devices were first developed in the early twentieth century [6]. By using active electrode and dispersive

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electrode that can more precisely control the flow of electrical current through only the targeted tissue area [7]. Bipolar apparatuses extraordinarily decreased the danger of security/remote harm and the measure of energy important to accomplish the coveted tissue impact [8].

3.2. Monopolar

In monopolar circuits, the current goes from the tip of the instrument (in the specialist's hand) to the tissue, to the arrival anode and back to the generator [9]. Contingent upon the situating of the patient plate in respect to the surgical operation, the current can affect pacemakers and metal prostheses. There is additionally the threat of consuming occurring far from the site of surgery [10]. The ideas presented in this are not new. In fact, the biophysical standards were all around depicted just about 90 years back. While numerous agents made early commitments, maybe Cushing and Bovie [11] composed the best materials. In addition, a superb content was composed in 1932 from the Hopkins early experience and examinations [10]. The fig 2 show clearly the Monopolar and Bipolar ES device.

Figure2: Monopolar and Bipolar [15].

4. Electrosurgical Generators

The generator-dynamic electrode–patient–return cathode the relationship can be appeared by a straightforward circuit including a power source (i.e., the ESU), a collection of resistance (the patient) [12] and to and from interfacing wires between the patient and electrode. The ESU regulates the information current from the outlet into that appropriate for use on living tissue. For safe application to the human body, a key trademark that must be modified is the recurrence of the AC. This depends on an essential perception on the impacts of current on creature muscle noted in 1786 by Luigi Galvani when he demonstrated muscle fits in frog legs optional to electrical possibilities evoked through galvanization in the metal snares in his suspension mechanical assembly [13]. Nevertheless, the most unfavorable impact of the 60-Hz recurrence is obstruction with a conductivity of the heart

muscle, bringing [12]. In Figure 3 output power waveform (electric voltage waveforms) available at the output of electrosurgical units for carrying out different functions.

Figure 3: Output power waveform [23].

5. Types of ESU generator

A controller is operable to limit the radio frequency output voltage developed across the output lines to at least a first predetermined threshold value to produce a cutting RF waveform [14] and a second threshold value to produce a coagulating RF waveform. Includes means for feeding the waveform to the three or more electrodes such that the cutting RF waveform is delivered between a first pair of the electrodes, and the coagulating waveform is delivered between a second pair of the electrodes [14]. As show in the fig4 below there are different type of generators which includes a radio frequency output stage having at least a pair of RF output lines, and a power supply coupled to the output stage for supplying power to the output stage [15].

Figure 4: Type of generators of ESU.

5.1. Spark gap generator

The Serbian-American architect Nikola Tesla proposed techniques to synchronize flashes with the pinnacle yield of an alternator, which he protected in 1896 [16]. In the mid-1890, Guglielmo Marconi utilized a start crevice transmitter in his tests to form the radio wonder into a remote telecommunication framework.In the chart below show the

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development stage of the spark gap generator. There are different types of solid state generators as show in fig (5) the progress in solid state generators from 1880 till 2000.

Figure 5: The progress in Solid state generator 5.2. Grounded and Isolated System

No Return Electrode cause patient skin burn, Electrode placement ECG Electrodes have least resistance to ground so site burn at electrode placement Current seeks shortest return side monitor, operating table [10].

5.3. Tissue Response Technology Recent Technology

Depicts the concept of widely varying tissue resistance/impedance in response [17]. using computer controlled for the tissue response instantly to changes in tissue impedance/resistance. Maintains clinical effect over a wide range of tissue impedances/resistances [7]. The analogy of on an automobile may be used: As the car needs more power to climb a hill, the cruise control feature will automatically deliver more gas so that the car can maintain the same rate of speed [18]. As the electrosurgical device needs more power to meet an increase in impedance/resistance in the target tissue, the generator will increase the voltage or amperage (current) to maintain the same wattage output [14]. The important point here is that the tissue response system will control the maximum output voltage and minimize sparking [19]. This contributes to many of the superior results seen in this technology, such as reduced drag, lower power settings and less tissue damage[20]. Computer controlled output is automatically adjusted [21]. Figure 6 show the Thermal damage in beneath this tissue, histological pictures look at the profundity of warm spread of standard ES versus Tissue Reaction (FX) [22]. Clearly show the new technique how it is affected.

Figure 6: Thermal damage [22].

These tissue histological pictures think

about the profundity of warm spread of standard ES versus Tissue Reaction (FX) [22]. There is half decrease in warm spread. Take note of that a comparable tissue impact has been created with a lower control setting bringing about lessened warm spread. The Force 2 was utilized as the standard ES generator. 6. Conclusion

From the early days of direct cautery and monopolar instrumentation, bipolar electrosurgical devices have evolved and enabled remarkable surgical outcomes in today’s technologically advanced operating room. Inherent in the bipolar design is an increased degree of electrosurgical safety, and through ongoing innovation, these instruments continue to enhance surgical efficacy and efficiency. Currently, a large variety of electrosurgical devices exist, each with its own unique characteristics and features, but comparative studies that allow meaningful analyses and evaluation are somewhat lacking. Further research is necessary and mandatory in order to keep pace with the rapid advancements in this field. Acknowledgement

The authors would like to thank the University Teknologi Malaysia (UTM) and Ministry Of Education (MoE) Malaysia for financial support through the research university grant (GUP) with vot 13H23.

Reference

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