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Diathermy
Diathermy
COURSE
IN SURGERY
TOPICS
A.
B.
C.
D.
DIATHERMY
LASERS
CRYOSURGERY
THERMOTHERAPY
BY
DIATHERMY
OUTLINE:
DEFINITION
HISTORICAL PERSPECTIVE
COMPONENTS
TYPES & SETTINGS [OF THE EQUIPMENT]
CLINICAL USES
COMPLICATIONS / HAZARDS
CONCLUSION
DEFINITION
HISTORICAL BACKGROUND
COMPONENTS : 3
i.
ii.
iii.
TYPES
A. Unipolar (Monopolar) D. - Most Common.
- Active & Return electrodes separated by
patients body (volume conductor).
B. Bipolar D. - Active & Return electrode
incorporated in one hand held diathermy
forceps.
- Separated by only few mms.
- Low power used.
SETTING
1. Cutting C. -
3. Blended C.
CLINICAL USES
Achieves a. Tissue fulguration (destruction and
necrosis).
b Electro coagulation
c. Electro dissection
Subspecialty Applications.
1. General surgery
- Endoscopic coagulation of bleeding DU
- Surgical dissection of GB from liver bed
during Lap. Cholecystectomy.
- Gastrotomy incision
- Colotomy incision
- Endoscopic excision of large int. polyp
- channelization of obstructing growths (Colon &
2. Urology
- TURP
- TURBT
- Excision of large hydrocele sac.
3. Vascular Surgery
- Endoluminal diathermy of long S.V.Varicose
veins.
4. Neurosurgery
- Haemostasis
- Tumor Excision
- Frontal leucotomy
Gynaecology
- Laparoscopic tubal sterilization
- Hysteroscopic fulguration of the uterine cornu
(sterilization).
- Treatment of cervical dysplasia.
- Lap. Treatment of peritoneal or ovarian
endometriosis.
To the Pt
Accidental; faulty cables; improper
placement of indifferent electrode.
4. 20 Haemorrhage
Excessive coagulation of
vessels with eventual
sloughing from large
vessel.
Ligature safer.
8. Electrocution
9. Fire explosion -
of patient
of surgical staff
from faulty or cracked cables.
Concomitant use of volatile
flammable anaesthetic gases
eg. Cyclopropane, ether.
Contact with flammable bowel
gases (methane, hydrogen) eg.
In colonic obstruction.
PRECAUTION
1. Cardiac pacemaker - Risk of interference,
ventricular fibrillation or
damage.
-
Avoid monopolar D.
CONCLUSION
- An indispensable surgical tool
- Facilitates fast, bloodless surgery
- Reduces No. of sutures & blood transfusion
- V. safe if adequate safety measures are taken.