A small piece of history ….
The first visionaries, in the age of the first transistors and radio equipment, observed that when manipulating the connection cables of the antenna, mild accidents occurred. Depending on the point which was touched, instead of creating a sensation of electricity or currents, there only occurred a quick, clean and non bleeding burn, with easy cicatrisation. It was simple to think that this would occur when the potency was low.
The first electronic instruments for cutting and coagulating in surgery were introduced in the 60s. Since then the technology has advanced in giant steps as well as the electro medicine in general.
Towards the end of the 70s, the earths makers dedicated more effort towards perfecting the old electro surgical equipment, and therefore there appeared units with the shape of a very perfected wave, with less necrosis and less collateral damage by the heat on the surrounding tissue, opening areas of work of surgery, with cutting and coagulation equipment, which were before reserved for the “cold” scalpel or steel scalpel: neonatals, plastics, aesthetics, neurosurgery, etc.
At the same time, the microelectronics have allowed the development of apparatus with reduced dimensions and weight, this helps each specialist to have his own unit , freeing them from depending on the institution where they are operating. Disposing of an independent work environment, providing security, shortening the exposition time of the patient and, definitively, minimizing adverse results.
In this context, in the last decade there have arisen advanced electronic units, portable electro scalpels and at accessible prices which offer better benefits than traditional ones, with infinite possibilities in different fields. However, in many current operating theatres they find themselves with service equipment which, although have a very modern appearance, form a part of the “honourable” beginnings of the electro medicine.
Multiple electro scalpels on the market with modern appearance
To mark the difference between the generation of equipments which are still valid but of an older technology, to the new generation of more sophisticated equipment, some manufactures launched the term [highlight_blue]RADIOSURGERY or RADIOFREQUENCY.[/highlight_blue]
Electro surgery (electro scalpel) against a radio surgery (radio scalpel)
In the market directed at surgery there are two types of instruments which differentiate by the frequency of their generator: electro scalpel and radio scalpel. They carry out similar functions. Just one accessory clearly dilates the type of equipment: the neutral electrode which in the case of the radio scalpel is called antenna and is covered by an insulation material which impedes the electric conduction through it but does allow the electromagnetic reception and emission.
The radio surgery consists in the pass of high frequency radio waves (RF, above 3, 5 MHz) pure and continuous through the tissue. The RF is an electromagnetic movement which provokes molecule agitation in tissues which hold a large quantity of water and salts, and are capable of driving electrical currents.
The resistance of the tissue to the current (between 5000 and 10000 ohms) produces energy in the form of heat. This heat is a product of electromagnetic fields and not of the sparks as with a conventional electro scalpel. The heat volatilizes the intracellular liquid, only on the point of contact of the electrode which remains cold, with the consequent vaporization of the tissue, without sparks or burns.
Radiofrequency against an electro surgery. The thermal collateral damage with a conventional electro scalpel is nearly doubled when compared with that produced by a modern radio scalpel.
Alternatively , the electro surgery uses a much lower frequency, between 0,3 MHz and 1,6 MHz. Due to the resistance produced when the electrical current passes through the body, the electrode heats up, this heat is transmitted directly by the contact to the tissue producing irregular cicatrisation .
The heat is a product of the sparks which are produced by the ionization of the gases or inflammation of the existing salts in the tissues which volatize by the excess of tension. The sparks destroy areas of tissue uncontrollably, holding a risk of bruising and small internal haemorrhages produced by the necrotic plug expulsed before the production of the cicatrisation of the vessel.
What is a radio scalpel or a radiofrequency scalpel?
A radio scalpel or radiofrequency scalpel is an apparatus of the latest generation which allows the modular of the electromagnetic current to achieve high frequency waves (up to 4 MHz), with frequencies and tensions of variable release depending on the conditions of the tissues upon which it is acting: thickness, impedance, humidity, temperature, electrodes used …
This way, a radio scalpel allows the coagulation and especially the cut of the skin and the tissues in a precise manner, with minimal collateral damage by the heat (burns and desecration). The simultaneous cut and coagulation of the skin produces, as a result, a clean wound, without bruising and with excellent cicatrization without risk of tattoos through calcinations or non aesthetic scarring.
Radiofrequency scalpel BM-780 II – Radiofrequency generator
[highlight_blue]In our Centre we have the radiofrequency generator BM-780 II of the German make Sutter®. [/highlight_blue]
This radiofrequency apparatus has an automatic function AutoRF which controls the state of the tissue and adjusts the potential in accordance with the structure and condition of the tissue.
Thanks to the function which it integrates (AutoRF), the BM-780 II is a radiofrequency unit which is more comfortable and safer. The results in the cut and the coagulation are optimal and the risk of being able to choose a level of power which is too high is reduced preventing the heating, harming or dryness of the tissue.
The auto adjust of the device avoids the dryness of the unwanted tissue in the area of the surgery and assures better surgical results without damaging the unwanted tissues.
The radio scalpel compared to a laser
The advances in electro medicine have also promoted the accession of the luminous or laser technology.
We believe that the obtained results and applications obtained in the clinical practice with laser do not always correspond with the commercial indications as many times the word “laser” is used more as a commercial and marketing tool rather than a real tool used in daily clinical practice.
Although we believe that in many aspects the luminous technology is and will be the base of modern surgery, today the laser does not provide demonstrated advantages in the cut and coagulation of tissues at hand.
The laser is a device with a high cost which is used with large terminals which do not allow comfort or precise use. As well as the dangers which come with the bad usage, an oversight or a bad adjustment of the parameters of the mechanism, we should presume that all the equipment used is passed through the appropriate revisions and controls.
With all of this, once the aspect of thermal collateral damage has been resolved with the radio scalpel, we can confirm that the practiced advantages of it in respect to the ablative laser for the cut and coagulation of the tissues are much greater.
Applications of the radio surgery
Click on the images to see the pdf files of information.
Through the different terminals available on the market, the [highlight_blue]applications of the [/highlight_blue] radio surgery are multiple in our field.
- [highlight_blue]Terminal of a short, straight or bended needle:[/highlight_blue] through the point of 0, 3 mm. Allows a clean, fine and safe micro cut without thermal damage which allows a very favourable cicatrisation: we use it in direct cutaneous cuts in blepharoplasty, lifting and skin and mucus biopsies.
- [highlight_blue]Ball terminal: [/highlight_blue] through the ball point with a 3 and 5 mm. diameter, permits a vaporization of the tissue similar to that produced by the ablative laser but much safer. With this terminal we eliminate nevus and cutaneous stains with excellent cicatrization.We also use it to vaporize leukoplakia lesions in the oral mucus.
- [highlight_blue]Long needle terminal : [/highlight_blue]: uwe use this terminal for the elimination of vascular spiders on the face (small hairs which dilate and can be seen on the skin).
- [highlight_blue]Loop terminal [/highlight_blue]: with it we eliminate cutaneous lesions more or less as big as seborrheic keratises.
- [highlight_blue]Bipolar tweezers with silver point[/highlight_blue] allow the coagulation of the vessels without burns. The silver helps to avoid the sticking of the point on the coagulated tissue.
- [highlight_blue]Terminal of radiofrequency or radioplasty [/highlight_blue]: Sutter has a specific terminal for facial radiofrequency which we use as an accompaniment to multiple treatments when its use is indicated for the treatment of the cutaneous flaccidity. The radiofrequency produces a gradual heat on the skin, acting principally on the existing collagen fibers, strengthening them and producing on the skin an effect called collagen genesis (formation of new collagen), creating the effect of contraction of the skin, and therefore reducing flaccidity.
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