Cautery surgery is a medical technique that employs heat or other methods to seal, remove, or destroy biological tissue. This practice has a long history in medicine, dating back to antiquity when hot metal instruments were used to stop bleeding. Modern advancements have transformed cautery into a precise and controlled surgical tool.
What is Cautery Surgery
Cautery in surgery serves several purposes, including tissue manipulation and hemostasis. It stops bleeding by sealing blood vessels, a process known as coagulation. Surgeons also use cautery to precisely cut through tissue, which minimizes blood loss. Beyond cutting and sealing, cautery removes or destroys abnormal tissue, such as tumors, warts, or other unwanted growths. This technique allows for targeted tissue destruction, especially in delicate areas, while also managing bleeding.
The Science Behind Cautery
Cautery works by applying energy, often heat, to biological tissue. This energy denatures proteins within cells, altering their structure and function. Heat also causes cellular water to vaporize, leading to tissue destruction. When applied to blood vessels, this process causes proteins in the blood and vessel walls to coagulate, sealing the vessel. For electrocautery, an electrical current passes through a resistant metal wire, generating localized heat for precise tissue effects, including cutting or coagulation.
Different Types of Cautery
Modern medicine primarily uses electrocautery, which generates heat via an electrical current. Electrocautery is categorized into monopolar and bipolar methods.
Monopolar Cautery
In monopolar cautery, the electrical current flows from a single active electrode through the patient’s body to a separate grounding pad, completing the circuit. This method allows for a wider range of tissue effects, including various cutting and coagulation modes.
Bipolar Cautery
Bipolar cautery uses two electrodes on the instrument tip, with the current flowing only between these two points. This creates a localized circuit that minimizes the current’s path through the patient’s body, reducing the risk of unintended burns. Bipolar cautery is generally used for precise, soft tissue coagulation.
Other less common forms include chemical cautery, which uses agents like silver nitrate or trichloroacetic acid to destroy tissue, and thermal cautery, which uses a pre-heated metal device.
Common Surgical Applications and Recovery
Cautery is a versatile tool used across many surgical specialties, including general surgery, dermatology, otolaryngology (ENT), and gynecology. It is employed for procedures like removing skin tags, warts, and moles, and addressing chronic nosebleeds. Surgeons also use it for excising tumors, during tonsillectomies, and in certain ophthalmic procedures.
Patients typically receive local or general anesthesia, depending on the procedure’s extent and location. Mild discomfort, redness, and swelling are common after the procedure. Recovery time varies, but healing typically occurs within two to four weeks. Post-operative care involves keeping the area clean and following healthcare provider instructions.