Electrosurgery: Principles, Risks, Safety Considerations, and Modeling of Thermal Effects

REVIEW
Branislav Radjenović, Marija Radmilović-Radjenović

 
For citation: Radjenović B, Radmilović-Radjenović M. Electrosurgery: Principles, Risks, Safety Considerations, and Modeling of Thermal Effects. International Journal of Biomedicine. 2025;15(4):645-648. doi:10.21103/Article15(4)_RA4
 
Originally published December 5, 2025

Abstract: 

Electrosurgery has significantly transformed modern surgical practices, offering a versatile and effective approach for cutting, coagulating, and desiccating biological tissue with remarkable precision. This review provides a comprehensive exploration of the fundamental principles that underpin electrosurgery, including the electrical mechanisms, tissue interactions, and the various types of thermal injuries that may arise during procedures. It categorizes thermal injuries into direct and indirect types, elucidating the unique risks associated with patients who have implantable electromagnetic devices. Furthermore, the review emphasizes the critical role of modeling thermal effects in electrosurgical procedures, highlighting how computational simulations can predict tissue damage and enhance safety measures. By deepening the understanding of these intricate concepts, surgeons are better equipped to optimize patient outcomes, minimize complications, and ensure the safe application of electrosurgical techniques. Ultimately, this review aims to bridge existing knowledge gaps and promote best practices in the field of electrosurgery, reinforcing its role as a vital tool in contemporary surgical settings.

Keywords: 
electrosurgery • thermal injures • electromagnetic devices
References: 
  1. Meeuwsen F, Guédon A, Klein J, Elst MV, Dankelman J, Van Den Dobbelsteen J. Electrosurgery: short-circuit between education and practice. Minim Invasive Ther Allied Technol. 2019 Aug;28(4):247-253. doi: 10.1080/13645706.2018.1513945. Epub 2018 Oct 12. PMID: 30311831.
  2. Biradar M, Dode P. Principles of electrosurgery in laparoscopy - A review. International Journal of Biomedical and Advance Research. 2019;10:e5163. Doi:10.21037/gpm
  3. Radmilović-Radjenović M, Sabo M, Radjenović B. Application of multi-component fluid model in studies of the origin of skin burns during electrosurgical procedures. Comput Methods Biomech Biomed Engin. 2021 Oct;24(13):1409-1418. doi: 10.1080/10255842.2021.1890721. Epub 2021 Mar 5. PMID: 33667151.
  4. Bisinotto FMB, Dezena RA, Martins LB, Galvão MC, Sobrinho JM, Calçado MS. Queimaduras relacionadas à eletrocirurgia – Relato de dois casos [Burns related to electrosurgery - Report of two cases]. Rev Bras Anestesiol. 2017;67:527-534. Portuguese. doi: 10.1016/j.bjan.2016.03.003.
  5. Ho CWG, Yang SH, Wong CH, Chong SJ. High-voltage electrical injury complicated by compartment syndrome and acute kidney injury with successful limb salvage: A case report and review of the literature. Int J Surg Case Rep. 2018;48:38-42. doi: 10.1016/j.ijscr.2018.04.039. Epub 2018 May 16. PMID: 29787959; PMCID: PMC6026718.
  6. Huschak G, Steen M, Kaisers UX. Elektrochirurgie--Grundlagen und Risiken [Principles and risks of electrosurgery]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2009 Jan;44(1):10-3. German. doi: 10.1055/s-0028-1128179. Epub 2008 Dec 29. PMID: 19115182.
  7. Vilos GA, Rajakumar C. Electrosurgical generators and monopolar and bipolar electrosurgery. J Minim Invasive Gynecol. 2013 May-Jun;20(3):279-87. doi: 10.1016/j.jmig.2013.02.013. PMID: 23659748.
  8. Takahashi Y, Enatsu R, Kanno A, Imataka S, Komura S, Tamada T, Sakashita K, Chiba R, Saito T, Mikuni N. Comparison of Thresholds between Bipolar and Monopolar Electrical Cortical Stimulation. Neurol Med Chir (Tokyo). 2022 Jun 15;62(6):294-299. doi: 10.2176/jns-nmc.2021-0389. Epub 2022 Apr 22. PMID: 35466117; PMCID: PMC9259081.
  9. El-Sayed MM, Saridogan E. Principles and safe use of electrosurgery in minimally invasive surgery. Gynecol Pelvic Med 2021;4:6(1-14). doi: 10.21037/gpm-2020-pfd-10
  10. Frivalssky M, Pavlek M.   Electro-Thermal Model of Liver Tissue and its Approximation. Biomedical Eng. 2019; 17:187-193. doi: 10.15598/aeee.v17i2.2872
  11. Hurst RD, Stewart CL. Hazards of surgical smoke from electrocautery: A critical review of the data. Am J Surg. 2024 Jul;233:29-36. doi: 10.1016/j.amjsurg.2024.02.017. Epub 2024 Feb 9. PMID: 38365552.
  12. Dufaye G, Cherouat A, Bachmann JM. Advanced modelling of the mechanical behaviour of biological tissues: application to 3D breast deformation. Comput Methods Biomech Biomed Engin. 2013;16 Suppl 1:305-7. doi: 10.1080/10255842.2013.815917. PMID: 23923952.
  13. Morrison TM, Dreher ML, Nagaraja S, Angelone LM, Kainz W. The Role of Computational Modeling and Simulation in the Total Product Life Cycle of Peripheral Vascular Devices. J Med Device. 2017;11(2):024503. doi: 10.1115/1.4035866. Epub 2017 Jan 23. PMID: 29479395; PMCID: PMC5823268.
  14. Lin CL, Lan GJ. A computational approach to investigate optimal cutting speed configurations in rotational needle biopsy cutting soft tissue. Comput Methods Biomech Biomed Engin. 2019 Jan;22(1):84-93. doi: 10.1080/10255842.2018.1535060. Epub 2018 Nov 6. PMID: 30398374.
  15. Radmilović-Radjenović M, Radjenović B. 2020. Studies of the origin of skin burns during electrocautery based on a multi-component plasma fluid model. J. Surg. Surgical Research 2020;6:27-29. doi:10.17352/2455-2968.000091

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Received July 16, 2025.
Accepted September 1, 2025.
©2025 International Medical Research and Development Corporation.