Treatments & Therapies

HF surgery – treatment, effect and risks

HF surgery

High – frequency surgery is a surgical procedure for cutting tissue, coagulating vessels or necrotizing various biological structures. The method has many advantages over standardized procedures and is mostly used successfully in microsurgery and neurosurgery , but also in general surgery .

What is HF surgery?

High-frequency surgery, also known as HF surgery , is an operative procedure to sever or damage tissue in a targeted manner. By applying high frequency alternating current, the energy thereby generated is converted into heat.

The resulting heat can cut tissue and biological structures can be necrotized or destroyed. The procedure of HF surgery is applied with a high frequency from 300,000 Hertz and therefore has its name. The purpose of a high frequency is to only slightly irritate the nerve tracts by frequently changing the flow direction. With a low frequency and the resulting slight change in flow direction, the nerve tracts are strongly stimulated. It can lead to an electric shock and thus to cardiac arrhythmia or acute cardiac arrest . This neuromuscular stimulus is also called the faradic effect.

A so-called electrolytic effect occurs during the application of high-frequency surgery. This means that there is an ion shift in the corresponding tissue structures. Due to the alternating current, the ions in the high-frequency range move back and forth at an increased rate, causing the ions to oscillate. The resulting thermal effect is used by the surgeon. Depending on the current density, duration of exposure and resistance of the tissue, coagulation or tissue transection occurs.

Function, effect & goals

HF surgery is used in almost all areas of surgery today. In many surgical treatments, the cutting and simultaneous closing of the blood vessels is used to advantage through this procedure. In this way, targeted cuts can be made through tissue structures without significant blood loss.The most common application is the treatment of damaged vessels in order to close them by means of so-called coagulation and stop the bleeding that occurs. Furthermore, benign and malignant fibroids and tumors are becoming increasingly devitalized and thus necrotic. The spectrum of applications for high-frequency surgery ranges from minimally invasive interventions to large coagulation incisions.

A special electrosurgical device is required for operative care using HF surgery. This consists of a generator that converts the supply current into high-frequency alternating current. The alternating current is then passed to a special instrument with a metal tip or metal tongs. This metal attachment is nothing more than a point-shaped active electrode. This creates a high energy concentration on the small active electrode and can achieve the desired electrosurgical effect at the application site. When using a metal tip, a so-called neutral electrode is applied over the entire surface under the tissue to be treated. This has no thermal effect and serves to close the circuit.

High-frequency surgery is divided into two methods of application technology. A distinction is made between monopolar and bipolar technology. These two techniques differ in the way the electric current takes to the neutral electrode.

With the monopolar technique, a narrow active electrode is used as an attachment, resulting in an increased alternating current concentration and thus an increased thermal effect. The neutral electrode is applied over a large area under the operation area. This method is used to cut and coagulate tissue structures. Compared to cutting with a scalpel, this technique has the advantage that there is no heavy bleeding. The surrounding tissue is spared and the spread of germs is prevented.

In the bipolar technique, the surgeon uses two-pole electrodes. The metal attachment is designed like a pair of pliers and is divided into two metal ends. The forceps consists of an active electrode and a neutral electrode. A separate neutral electrode is not required here. By using these metal tips, both poles are in contact with the operating area. This technique is mostly used in neurosurgery and microsurgery in order to use the thermal effect for coagulation and thus to close vessels.

When using high-frequency surgery, it should always be considered that the different biological structures also have different resistance forces. For blood , for example, this is 0.16 x 10 ohmmeters, compared to 3.3 x 10 ohmmeters for fatty tissue . To ensure the safety of the patient, it must be ensured that the patient is stored dry and isolated, that there is no contact with a grounded device and that there is no skin contact with the doctor or assistant. The surgeon should wear special gloves during the procedure

Risks, side effects & dangers

If the surgeon adheres to all specified safety and hygiene standards when using high-frequency surgery, this is a very safe surgical method.For example, if the neutral electrode is forgotten or applied incorrectly, severe burns can result. The current is then not returned to the generator, but is diverted via the operating table or other grounded equipment. If burns occur on the patient, a distinction is made between endogenous, exogenous and pseudo burns. Endogenous burns occur when the current density in the tissue is too high. This can happen, for example, if the patient comes into contact with conductive and grounded equipment during the procedure.

Exogenous burns, on the other hand, result from the combustion of liquids or gases. This can lead to small explosions and thus burns. These explosions can be caused by skin disinfectants or anesthetic gases. Pseudo-combustion is when the cause is neither endogenous nor exogenous.

Furthermore, it should be noted that cardiac pacemakers can be damaged by the use of HF surgery. Therefore, the risk should be weighed up and an internist should be consulted if necessary.

Lisa Newlon
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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.