Editing Electrosurgery (section)

== '''Tissue manipulation:''' ==

* Cut = continuous waveform which produces heat rapidly and vaporises tissue
** Hold electrode slightly away from tissue to focus heat
* Blend 1-3: progressive decrease in the 'duty cycle' length, causing a gradual change from cut to coag. Blend 1 is close to 'cut', while blend 3 is close to 'coag'.
* Coag = higher voltage, shorter bursts. Produces a coagulum instead of vaporising.
* The only variable which determines whether one waveform vaporises tissue and another produces a coagulum, is the rate at which heat is produced.
* Dessication occurs when the instrument is held directly against a vessel - lower temp, dries and denatures and forms thrombus. Note that this is normally achieved using a forceps.
* Fulguration - superficial coagulation over a wide area - achieved by applying energy without making tissue contact
* Electrovaporisation
** E.g. Prostate ablation