Treatments & Therapies

Electrocoagulation – Treatment, Effects & Risks

Electrocoagulation

Electrocoagulation is a surgical procedure in HF surgery in which tissue is intentionally damaged and removed using high-frequency current. In this context, the procedure can be used on tumors , for example , and closes the resulting wound at the same time as the incision is made. Electrocoagulation cannot take place in extremely dry tissues.

What is electrocoagulation?

In high-frequency surgery, a team of doctors directs high-frequency alternating current through the human body. The HF method aims to damage or cut tissue in a targeted manner. Tissue structures are to be severed or completely removed.

In contrast to the conventional cutting technique, the wound can be closed together with the incision in HF surgery. This stops the bleeding because the vessels in the incision area are closed. The instrument used in HF surgery is the electroscalpel. A procedure from this surgical area is electrocoagulation. During electrocoagulation, a single spark is emitted that burns the tissue in a point-like manner, separating tissue structures from one another.

The fast and at the same time efficient electrocoagulation and the associated hemostasis is used primarily in the context of a lack of spontaneous coagulation, for example in the case of bleeding in connection with tumors. In the case of rather small vessels, the procedure replaces expensive fibrin glue or ligatures. Electrocoagulation thus saves the doctor both effort and money. The patient also benefits from the HF surgery procedure thanks to the immediate hemostasis.

Function, effect & goals

The term coagulation can refer to two different surgical techniques. In addition to deep coagulation, there is electrical hemostasis in the sense of electrocoagulation. Deep coagulation is also electrocoagulation. The process heats the tissue up to 80 degrees Celsius.

The heating is achieved via electrodes. In this context, roller electrodes are used in addition to ball and plate electrodes. These instruments are used to remove tissue during the course of the operation. A high current density is used in electrocoagulation in the sense of deep coagulation. 

Only current without pulse modulation is used, i.e. unmodeled current. The doctors influence the depth of the coagulation via the magnitude of the current. When large current is used, smut forms. The heat can thus not spread further into the depths.

Later, when the electrode is removed, the doctor removes the burned tissue that is still attached to the electrode in the same step. If low current is used for too long an exposure time, the tissue around the electrode will boil away. The burns reach slightly deeper than the electrode diameter. 

In contrast to deep coagulation, pulse-modulated HF current, which is attached to clamps and tweezers, is used for electrocoagulation in the sense of a hemostasis process. The tips of the instruments grip the area to be breastfed, which narrows due to dehydration and ultimately closes completely.

This coagulation process takes place in bipolar operation. Monopolar forceps are rarely used. Hemostasis on oozing hemorrhages takes place with large-area electrodes that are operated via pulse-modulated current. Other forms of coagulation are desiccation and fulguration. These are special forms of the process. 

Fulguration is performed as superficial coagulation. In this procedure, intracellular and extracellular fluid vaporizes due to the arcing of sparks from a tip of the electrode, which the doctor guides a few millimeters over the tissue.

Desiccation generally corresponds to this procedure, but with this type of coagulation, the needle electrode is inserted into the tissue. Currents below 190 V are referred to as soft coagulation. 

These processes do not create sparks or arcs. In this way, unintentional cutting is excluded and carbonization is prevented. In addition, there is forced coagulation, which ranges up to currents of 2.65 kV and generates electric arcs for a greater depth of coagulation. Spray coagulation, on the other hand, works with currents of up to 4 kV and thus creates particularly strong and long arcs in order to heat the tissue both exogenously and endogenously.

Risks, side effects & dangers

Electrocoagulation is associated with some risks and side effects. As usual, the patient has to reckon with the conventional risks and side effects of any operation. These include, for example, unwanted bleeding, circulatory collapse due to the anesthetic or complications in the throat area that can occur from the ventilator .

Like all other surgeries, electrocoagulation can cause nausea or vomiting due to the anesthetic . In addition, more or less severe pain can occur in the treated areas. In addition to the conventional surgical risks, electrocoagulation is associated with some specific risks and complications. 

This includes, for example, the sticking effect, which can occur with both soft coagulation and forced coagulation. With higher amperages, an unexpectedly high level of sparking cannot be completely ruled out, which in extreme cases can inadvertently injure or even remove tissue.

However, this risk is negligible as long as the patient is in the hands of professional HF surgeons who perform the procedure several times a day. Under certain circumstances electrocoagulation is not possible.

This applies, for example, when the tissue is extremely dry. In dry tissue, there is insufficient current flow. For this reason, such tissue cannot be electrocoagulated at all. Before the planned coagulation, the doctors must therefore determine exactly how dry the tissue to be treated is.

Website | + posts

Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.