What are radiofrequency electrocautery devices used for?

Here, Mr Mahantesh Karoshi, a highly experienced consultant gynaecologist, explains what radiofrequency electrocautery devices are typically used for, and reveals whether not these devices can be used as a treatment option for fibroids.  

What are radiofrequency electrocautery devices used for?

Radiofrequency electrocautery devices have been in use for more than 70 years to achieve direct tissue ablation, usually to reduce blood loss during surgical procedures. 

Advances in electrocautery technology have led to the development of monopolar and bipolar tissue ablation devices designed to destroy larger areas of tissue, particularly malignant tumours. 

When cells are heated above 45° to 50°C, intracellular proteins are denatured and cell membranes are destroyed through dissolution and melting of lipid bilayers. Thus, thermal ablation produces direct cyto-destruction in treated tissues. 

Radiofrequency ablation (RFA) is a localised thermal treatment technique designed to destroy tumours by heating tumour tissue to temperatures that exceed 50°C. 
 

Can radiofrequency electrocautery devices be used to treat fibroids?

In recent years, radiofrequency ablation (RFA) of fibroids has been presented as a less invasive alternative to treating symptomatic fibroids. RFA was developed by adopting techniques used to treat solid liver tumours and adapting them to the management of fibroids.

RFA uses real-time ultrasound to identify the fibroids and apply radiofrequency energy from a handpiece using a transcervical approach. Ultrasound guidance allows for the placement of radiofrequency needles directly into the fibroid to target local treatment to only the fibroid tissue only. 

Radiofrequency fibroid ablation produces hyperthermic energy that induces coagulative necrosis of the fibroid. Once the fibroid undergoes coagulative necrosis, the process of fibroid resorption and volume reduction occurs over weeks to months depending on the fibroid size. 

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