Current technological advances of bipolar coagulation.
BACKGROUND
Heat has been used to control bleeding for thousands of years. In the 1920s, this concept was applied to the development of electrosurgical instruments and was used to control hemorrhage during surgical procedures. In the time that has passed since its first use, electrosurgery has evolved into modern-day bipolar technology, involving a diverse group of coagulation instruments.


METHODS
We review the evolution and advances in electrosurgery, specifically bipolar coagulation, and the current technologies available for intraoperative hemorrhage control.


RESULTS
Electrosurgery has evolved to include highly accurate devices that deliver thermal energy via nonstick and noncontact methods. Over time, the operative range of coagulation instruments has increased dramatically with the incorporation of irrigating pathways, a wide range of instrument tips to perform various functions, and the application of bipolar technology to microforceps and microscissors for minimally invasive procedures.


CONCLUSIONS
Electrosurgical devices and techniques, especially bipolar coagulation, have developed significantly with the availability of new technologies. This has led to better intraoperative coagulation control while minimizing iatrogenic damage associated with heat spread and tissue adherence, thus potentially improving outcomes for neurosurgical procedures.
Vellimana
Ananth K
AK
Department of Neurological Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Sciubba
Daniel M
DM
Noggle
Joseph C
JC
Jallo
George I
GI
D001777:Blood Coagulation; D004598:Electrosurgery / Q000295:instrumentation* / Q000379:methods*; D006488:Hemostasis, Surgical / Q000295:instrumentation* / Q000379:methods*; D049673:History, 20th Century; D006801:Humans; D020300:Intracranial Hemorrhages / Q000628:therapy*; D007431:Intraoperative Complications / Q000628:therapy*; D009493:Neurosurgery / Q000295:instrumentation* / Q000379:methods*; D013525:Surgical Instruments / Q000266:history; D007507:Therapeutic Irrigation