The governing concept that applies to electricity is Ohm's law and its three variables affect the temperature that the tissue reaches. Consequently, snares, endoknives and sphincterotomes are the active electrodes of this electrical circuit. The heating that we produce in the cells is used to cut, coagulate or ablate by adjusting various parameters. The physical basis of electrosurgery is the use of high frequency alternating current that is delivered to the tissue and transformed into thermal energy. Principles of electrosurgery The physics: basic principles Definitely, when we know better, we perform at our best. The lines below are an attempt to explain some physical bases and electrosurgical principles to improve our understanding and management of the ESUs and, therefore, our patients’ safety. While the final electrosurgical result in the tissue depends on numerous factors concerning the patient, the lesion, the user technique and the device, an adequate knowledge of our ESU is key. Why on earth a racing driver would steer his car without fully understand the machine? A lack of specific training, confusing terminology and varied proprietary technologies may contribute to this picture. As the years go by, more and more therapeutic interventions are scheduled in our endoscopy rooms and the common general knowledge on ESUs remains to be improved. This situation was really striking, particularly when you consider all the endoscopic resections, sphincterotomies and hemostatic procedures that we performed every day. However, when we asked our mentors how the ESUs works or why to apply any given setting, the answer was usually quite unsatisfactory with a few honorable exceptions. In fact, a wide number of the procedures in our endoscopy units required diathermy. Thank you.When we were trainees, we observed that one of the main tasks undertaken by the senior endoscopists involved the usage of electrosurgical units (ESUs). If you found this page helpful please consider making a donation. Laparoscopic surgery for endometriosis Information PackĪs a charity, Endometriosis UK relies on support from people like you. The decision to have either of these procedures is a big one to make – they are irreversible, so the advantages and disadvantages of each surgery should be discussed in full with your consultant.įor further information on radical surgery, download our resources These procedures may be considered for a number of reasons. When both ovaries are removed, the surgical procedure is called “bilateral oopherectomy,” whereas the removal of only one ovary is called “unilateral oopherectomy.” When both ovaries are removed, a woman will experience an instant and irreversible menopause. Oopherectomy is the removal of the ovaries. Remember that a hysterectomy is irreversible. Consider all options and discuss things fully with your GP or gynaecologist. Hysterectomy is not the right operation for everyone and not a decision to make lightly. Some women need a further operation to remove the ovaries at a later date. If the ovaries are left in place then the chance of endometriosis returning is increased. It can be done with or without removing the ovaries. Hysterectomy is the removal of the womb, and is performed under general anaesthetic. Radical surgery refers to a hysterectomy or oophorectomy. More radical surgery can be considered if a woman has not responded to drug treatments or conservative surgery and is not planning to start a family. Any complex surgery should be discussed thoroughly with your doctor or specialist. These types of surgery will often include a multi-disciplinary team such as a colorectal surgeon, and are usually carried out via laparoscopy. Read more about how to prepare for a laparoscopyĭepending on the severity of your endometriosis, you may need to undergo more complex surgery that involves different organs within the body, such as the bowel or the bladder. Please see our factsheet on laparoscopic surgery for endometriosis for more details. Although surgery can provide relief from symptoms, they can recur in time. The surgeon can either cut out the endometriosis (known as excision) or destroy it using heat or laser. There are three options of surgery for treating endometriosis:Ĭonservative surgery aims to remove or destroy the deposits of endometriosis and is usually done via a laparoscopy (keyhole surgery). As a treatment for endometriosis, surgery can be used to alleviate pain by removing the endometriosis, dividing adhesions or removing cysts.
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