Despite the daunting implications of a term like ‘electrosurgery’, it’s fascinating to think that the technology behind it has existed for nearly 90 years. Much like cauterization, in which electrical current is used to heat up a probe during a medical procedure, electrosurgery utilizes electrical current to cut, destroy, or coagulate tissues without the use of a traditional cutting tool like a scalpel. For instance, electrosurgery would likely be employed in procedures where bleeding is a serious risk to the patient. The two most important elements of any device used to perform electrosurgery are the generator and a handheld device known as the RF knife, which is popularly referred to as a ‘Bovie’. It should be no surprise that this nickname originates from the creator of the first electrosurgical device, William T. Bovie.
Almost 20 years after the first electrosurgical procedure was performed at Brigham Hospital, a lower-powered and more affordable device was created known as the hyfrecator. This remains a generic term used to denote any device utilized on conscious patients for electrosurgical procedures, although only devices made by the ConMed Company have patent over the term. The most commonly used hyfrecator is a model named the ConMed Hyfrecator 2000 Electrosurgical Generator (sometimes abbreviated as ConMed ESU), which, at the time of this post, remains the highest-selling brand in the nation. The ConMed ESU also provides the added benefit of variable power settings. As one might imagine, this is a useful feature due to the number of different medical procedures that might call for more sensitive and precise manipulation of the device, such as removal of warts, electrocauterization of small arteries, or destruction of skin cancers.
A low-powered hyfrecator like the ConMed ESU owes much of its dominance in the field to its widespread utility across many different avenues of medicine. These would include fields as diverse as dentistry, gynecology, and even veterinary medicine. However, the one caveat that we haven’t discussed yet is the fact that, to perform electrosurgical procedures, the device has to literally pass pulses of AC electrical current into your skin through an electrode, at which point the tissue is either cauterized or destroyed. Apparently, due to the high-frequency of the current utilized by devices such as the ConMed ESU, the patient undergoing the procedure doesn’t feel pain from the electricity—instead, it is often the heat generated from the burning of tissue that causes discomfort to the patient! Amazingly enough, the pain is usually so slight during the more common procedures (like skin tag removal or wart removal) that the patient often requires no anesthesia.