Performing surgery with a single electron: electrosurgery and quantum mechanics*
Abstract
Electrosurgery is the surgical application of a high frequency electric current (200 kHz–3.3 MHz) as a means to cut, coagulate or otherwise alter biological tissues.1,2 The use of electricity in surgery first began in 1881 with Morton's observation that alternating currents (ACs) less than 100 kHz in frequency did not induce muscle spasms or pain in patients, allowing the electricity to pass through them innocuously.3 In 1891, d'Arsonval noted that the temperature of a patient's tissues increased proportionally to the square of the current passing through the tissues. Six years later, Nagelschmidt coined the term ‘diathermy’ to describe this phenomenon of heating (not destroying) tissues through the application of an AC.3 In 1900, a Parisian physician, Joseph Rivere, whilst treating an insomniac with the new technique of diathermy, serendipitously saw an arc of electricity from the electrode desiccate a small area of the patient's skin. He consequently applied the arcing current to an ulcerating tumour on the patient's hand – the first true medical application of electrosurgery3. During the first two decades of the 20th century, grounding plates were added to increase the effective range of the current and the terms electrocoagulation, fulguration and desiccation were coined.3 The more renowned period of progress in electrosurgical technology and techniques was set in motion by William T. Bovie, a man described as ‘an eccentric inventor with a doctorate in plant physiology’1…
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