Electrosurgery: Advantages and Disadvantages

This page explores the advantages and disadvantages of electrosurgery, a technique used for soft tissue cutting using electrical currents.

What is Electrosurgery?

Electrosurgery involves performing surgery using electrical devices. It leverages high-frequency alternating electrical current at various voltages to generate heat. This heat can be applied to biological tissue to:

• Cut
• Coagulate (control bleeding)
• Desiccate (dry out)

In dentistry, electrosurgery is used to cut soft tissues in the mouth and sculpt live tissues without pressure while simultaneously controlling bleeding. Electric current is delivered to the targeted tissue area via cables and electrodes.

Image Courtesy : Springer Nature Switzerland AG. Book on “Fundamentals of Electrosurgery Part I: Principles of Radiofrequency Energy for Surgery”

Electrosurgery typically operates between 200 KHz and 3.3 MHz. Two main device types are used for energy delivery: monopolar and bipolar.

Figure 1 (shown above) illustrates monopolar and bipolar electrosurgery.

• Monopolar: This device delivers current through an active electrode. The current travels through the patient and returns to the generator via a pad attached to the patient (conductive adhesive grounding pad).
• Bipolar: Resembling surgical forceps, the bipolar device incorporates both active and return electrodes at the surgical site. Energy is confined to the tissue between the forceps, preventing it from traveling through the entire patient. This ensures minimal unintended current dispersal.

Figure 2 (shown above) shows the use of electrosurgery in dental services.

Benefits or Advantages of Electrosurgery

Here are the benefits of electrosurgery:

• Easy to Manipulate Electrodes: The electrodes (or wires) used in electrosurgery are easily bent, facilitating the smoothing of soft tissues.
• Versatile Cutting: Electrodes can cut both at their side and at the end, enabling deep cutting of soft tissues.
• Fast Cutting Speed: The cutting speed is significantly faster compared to methods like diode lasers.
• Relatively Painless: Electrosurgery can be performed with minimal discomfort.
• Improved Results with Cleaning: Cleaning the electrodes during the operation ensures consistent, fast, and better results.
• Precise Cuts: Electrode tips can be changed to pencil shapes for narrow and precise cuts.
• Inexpensive Method: Electrosurgery is a relatively inexpensive surgical method.
• Self-Disinfecting Electrodes: The electrodes possess self-disinfecting properties.

Drawbacks or Disadvantages of Electrosurgery

Here are the drawbacks of electrosurgery:

• Strong Odor: Electrosurgery produces a stronger flesh-burning smell compared to diode laser techniques.
• Lingering Taste: The taste of burnt flesh can linger in the mouth for an extended period.
• Anesthesia Required: Patients typically require anesthesia for electrosurgery procedures.
• Risk of Overcutting: The rapid cutting speed can lead to overcutting if the practitioner is not careful.
• Heat Production: The high heat produced during cutting limits its use near implants. Diode lasers are preferred in these situations.