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Electrosurgery

Last updated May 19, 2021

Written by: Lester Fahrner, MD

Reviewed by: Lester Fahrner, MD

Approved by: Krish Tangella MD, MBA, FCAP

Electrosurgery is a procedure in which an electric device is used to generate high-frequency electrical current to apply to living tissues for various purposes.


Background Information:

What are the other Names for the Procedure?

  • Bipolar Electrocoagulation
  • Electrocautery
  • Electrosection

What is Electrosurgery procedure?

  • Electrosurgery is a procedure in which an electric device is used to generate high-frequency electrical current to apply to living tissues for various purposes. It can be used to achieve superficial or deep coagulation of bleeding, or to cut through tissues
  • Electrocautery as a procedure does not transmit electricity into the skin. Instead, a metal tip is heated red-hot with electric current, and only the heat enters the skin to cauterize

What part of the Body does the Procedure involve?

The Electrosurgery procedure involves any of the living tissues of the body containing water. It is not used on nail plates or hair.

Why is the Electrosurgery procedure Performed?

There could be a variety of reasons for performing Electrosurgery procedure. Some of these include:

  • Controlling pinpoint bleeding on superficial areas of skin surgery
  • Controlling bleeding with larger vessels, in any variety of internal organs that are directly visualized
  • Electricity can be directed through scalpel blades, which can then cut with very little effort through tissues, with simultaneous control of small points of bleeding, with follow-up cautery required only for larger vessels
  • With small enough needles and low enough current, fine hair follicles can be destroyed, a process known as electroepilation
  • Small benign and malignant growths of the skin can be destroyed with Electrosurgery

What are some Alternative Choices for the Procedure?

Some of the alternative choices for Electrosurgery include:

  • Larger vessels must always be tied-off with sutures
  • Some functions of Electrosurgery can be performed instead with lasers

What are the Recent Advances in the Procedure?

Currently, no significant advances specific to Electrosurgery procedure are reported.

What is the Cost of performing the Electrosurgery procedure?

The cost of the Electrosurgery procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the Electrosurgery procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

https://www.aad.org/ (accessed on 05/16/2021)

Prior to Electrosurgery procedure:

How is the Electrosurgery procedure Performed?

The Electrosurgery procedure is performed in the following manner:

  • The appropriate polarity of the current (monopolar or bipolar) for the treatment is determined
  • The lowest level of voltage required to achieve the expected result is chosen, and adjusted as necessary
  • Brief pulses of Electrosurgery are used, activated with a footplate or a switch on the handpiece, with the metal tip in contact with the spot of bleeding

Where is the Procedure Performed?

The Electrosurgery procedure is usually performed in a clinic procedure room, a hospital, or an outpatient surgical procedure suite.

Who Performs the Procedure?

The Electrosurgery procedure is usually performed by a surgeon or surgeon’s assistant. The training and background of the operator can be that of physician, physician’s assistant, advanced practice, or surgical assistant.

How long will the Procedure take?

The Electrosurgery procedure usually takes very brief moments within a surgical session. The amount of time spent performing the electrosurgical component is quite variable.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the procedure and helps avoid complications.

  • If you have any implanted electrical devices. This includes pacemakers, defibrillators, deep brain stimulators for seizures or Parkinson’s Disease, or implanted pain control devices
  • If you have prolonged bleeding from an inherited bleeding disorder, are taking anticoagulants, or have decreased or low functioning platelets
  • If you have any metal dermal piercings

What Preparations are needed, prior to the Procedure?

The physician performing the procedure will evaluate the patient prior to the procedure and discuss the details with risks for complications and obtain his/her permission (termed informed consent).

  • Only the usual preparations for the primary surgical procedure are needed
  • Those with metal dermal piercings on their back will need them surgically removed from their skin to avoid burns from them functioning as an electrical ‘ground’

What is the Consent Process before the Procedure?

The physician will obtain permission for the Electrosurgery procedure using an Informed Consent Form. For Electrosurgical components of a larger procedure, specific consent is generally not added.

Consent for the Procedure: A “consent” is the approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

In case of minors and individuals unable to give informed consent, the parent or legal guardian or next of kin can sign the consent for the procedure.

What Tests are needed, before the Electrosurgery procedure?

In many cases, no tests are typically necessary prior to the Electrosurgery procedure. However, if required, the healthcare provider may recommend the following tests such as:

  • Blood tests for possible coagulation problems
  • For those with implanted electrical devices, the representative of the manufacturer may be needed in attendance to inactivate the device to protect it from external electric damage, and reactivate it at the completion of the procedure

What are some Questions for your Physician?

Some of the questions that you might ask your healthcare provider are as follows:

  • What is an Electrosurgery procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed? 
  • What are the risks while performing the procedure?
  • What are the complications that might take place during recovery?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • What are the costs involved?
  • Will my pacemaker or other device be adversely affected?
  • Will my metal piercings affect the procedure in any way?

During the Electrosurgery procedure:

What kind of Anesthesia is given, during the Procedure?

Local anesthesia by injection, and whatever anesthetic used for more extensive procedures will be used.

How much Blood will you lose, during the Procedure?

There is not much blood loss during an uncomplicated Electrosurgery procedure.

What are the possible Risks and Complications during the Electrosurgery procedure?

As a generally superficial procedure, complications are rare from an Electrosurgery. In some cases, poor immune system due to a variety of causes, may increase one’s risk of complications during the Electrosurgery procedure.

Some of the possible risks and complications that may arise during an Electrosurgery procedure include:

  • Infection
  • Bleeding
  • Injury to the neighboring structures
  • Pain and discomfort
  • Electric shock from a malfunctioning or poorly-grounded device

What Post-Operative Care is needed at the Healthcare Facility after the Electrosurgery procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise.

After the Electrosurgery procedure:

What are the possible Risks and Complications after the Electrosurgery procedure?

The risks and complications that may arise after Electrosurgery include:

  • Excessive bleeding that may sometimes require an additional surgical procedure
  • Infection of the surgical wound

What is the Prognosis after the procedure?

In a majority of cases, the prognosis after a Electrosurgery procedure is typically excellent.

When do you need to call your Physician?

Do contact your physician or call 911 (or your local emergency number) based on the seriousness of any of the following symptoms:

  • Fever and chills
  • Severe pain
  • Shortness of breath
  • Bleeding or fluid discharge from the surgical wound
  • Nausea and vomiting
  • Signs of infection
  • Severe fatigue
  • Dizziness

What Post-Operative Care is needed at Home after the Electrosurgery procedure?

At home, the following post-operative care is recommended after the Electrosurgery procedure:

  • Resume showering and keep the wound clean and dry. Gently wash the surgical wound with mild unscented soap
  • Replace dressing after showering
  • Apply petrolatum or other topicals indicated by your surgeon
  • Take the prescribed medications following the procedure
  • Avoid any strenuous activity for a period recommended by the physician
  • Avoid smoking or drinking alcohol post-procedure
  • Continue old prescribed medications after checking with your healthcare provider

How long does it normally take to fully recover, from the Procedure?

The recovery time usually depends on the extensiveness of the surgery. Simple procedures have shorter recovery periods of a week or so; while, it may take several weeks to a month for some deeper procedures.

Additional Information:

What happens to tissue/samples (if any), taken during the Procedure?

The procedure does not involve the surgical removal of any tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Electrosurgery procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The outpatient facility or hospital
  • The dermatologist
  • The anesthesiologist if he/she was involved in the procedure

The patient is advised to inquire and confirm the type of billing, before the Electrosurgery procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 19, 2021
Last updated: May 19, 2021