Principles of electrocautery-based techniques

Abstract

This discussion will focus on the technical aspects of electrosurgical techniques used in the surgical treatment of BPH. The core principle of electrosurgery is the application of electrical current to tissue results in heating of the tissue and desired effects on the tissue. The given effect on the tissue largely depends on the rate of temperature rise in tissue, which can be controlled by adjusting the settings of the electrosurgical generator. Tissue effects include cutting, coagulation, vaporization, desiccation, and fulguration. Monopolar techniques require a large dispersive pad located on the patient, while bipolar techniques feature both active and return electrodes built into the resectoscope. Bipolar resection can be carried out in a saline medium, which for all practical purposes removes the risks of TUR syndrome and dilutional hyponatremia observed with monopolar TURP.