What is the Bipolar Cautery?

Maggie J. Hall

A surgical procedure involving bipolar cautery uses electrical current through a medical device, which generally cuts through human tissue and or seals bleeding vessels. Surgeons often combine this type of surgical instrument simultaneously with some type of fluid irrigation that to control the amount of tissue damage occurring during surgery. A number of medical fields typically use bipolar cautery including dentistry, general surgery and neurosurgery.

Bipolar cautery may allow patients to experience less blood loss and as a result require fewer transfusions.
Bipolar cautery may allow patients to experience less blood loss and as a result require fewer transfusions.

The main part of the cauterization device is usually comprised of a forceps type instrument, and high frequency electrical current runs from one tip to the other. One tip of the apparatus might be used for cutting and the other for sealing blood vessels. Depending on the model of the instrument, one tip may also be hollow and act as a suction device. The power source of the bipolar cautery device generally has multiple frequency settings, allowing surgeons to cut, cauterize or perform a combination of functions with the same instrument. A fine looped wire might be attached from one tip to the other for removing polyps or larger areas of tissue.

Bipolar cautery may be used to treat hemorrhoids.
Bipolar cautery may be used to treat hemorrhoids.

Synchronized saline or medicinal irrigation can provide a cushion between the electrocautery instrument and the tissue, which often becomes dehydrated and shrinks during surgery. The electricity and heat produced by the electrodes burn the tissue, causing it to stick to the device. Surgeons may opt to use irrigation fluid to prevent this process from occurring, depending on the type of procedure performed.

The fluid might also be used as a cutting extension of the instrument. As the electrodes heat the water, the steam produced heats the tissue, cutting away the designated amount at the depth desired. The amount of current used for different procedures varies with body location, type of tissue, and the treatment required.

Compared to other cauterization methods, bipolar cautery allows surgeons to accurately and delicately move and remove diseased areas without causing extensive damage to adjacent or deeper tissue. By immediately searing affected blood vessels, surgeons usually spend less time performing the procedure, and patients generally experience less blood loss and require fewer transfusions.

Bipolar cautery has a wide array of surgical applications. Oral surgeons might use the procedure as a method of removing diseased gum tissue and bipolar cautery in general surgery often effectively treats hemorrhoids. The precision of the instrumentation and technology also allows neurosurgeons to perform delicate procedures involving microscopic blood vessels and nerves.

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