Diathermy.

This presentation is open for all to see and get benefitted

1. - DIATHERMY Dr Nisar Ahmed Arain Assistant professor Anesthesia/Critical Care/ER

2. -OBJECTIVES --Introduction --Forms of Diathermy --Surgical uses and Types of Diathermy --Complications

3. -INTRODUCTION --Diathermy is a form of physical therapy in Which heating of Deep tissues is accomplished by the use of high frequency electrical current --The term Diathermy is derived from the Greek words “Therma” meaning heat and “Día” meaning through. --Diathermy literally means “Heating Through” -- ”Carl France Nagelschmidt” , a German physician, in 1909 coined the term Diathermy

4. -USES --Depending on the amount of Heat generated, Diathermy can be used to merely warm or to Burn the tissues --In the first instance, it is particularly beneficial in relieving muscle soreness and sprain. --In the second instance as an adjunct to surgery, Diathermy is used to a-Coagulate b-Prevent excessive bleeding and c-Seal off traumatized tissues --It is particularly effective in a-Eye surgery b-Neurosurgery and c-Dermatology

5. -Forms of Diathermy --There are Three forms of Diathermy which are widely used in the Hospitals like a-SHORTWAVE b-ULTRASOUND c-MICROWAVE

6. --In short wave diathermy, the body part to be treated is placed between two condenser plates, and the highest temperature is concentrated in the subcutaneous tissues --It is usually prescribed as treatment for the Deep Muscles and Joints and is sometimes used to localized deep inflammatory diseases -SHORT WAVE DIATHERMY

7. --It uses high-frequency acoustic vibrations and there heating effect increases “Circulation and Metabolism” and speed up the rate of ion diffusion across the cellular membranes affected --Ultrasound is used to heat selected muscles which are too deep to be significantly affected by surface heating. -ULTRASOUND DIATHERMY

8. -MICROWAVE DIATHERMY --Microwave Diathermy uses radiation of very high frequency and of short wave length just similar to Radar waves --It creates heating effect --Micro wave Diathermy is used in the management of significant tumors with conventional RT and C T

9. --Surgical Diathermy is usually better known as “Electrosurgery” (It is also reffered to occasionally as “Electrocautery” Electrosurgery and surgical Diathermy involve the use of high frequency A.C electrical current in surgery. -ELECTRO CAUTRY

10. -SURGICAL DIATHERMY MACHINES

11. -SURGICAL USES Diathermy can be used for three purposes --COAGULATION:- Sealing of blood vessels --FULGURATION:- The destruction coagulation of tissues with charring --CUTTING:- It is also used to divide tissues during bloodless surgery

12. --MONOPOLAR --BIPOLAR -TYPES OF DIATHERMY

13. -Presentations of Electro-Surgery Techniques

14. -MONO-POLAR DIATHERMY --Where electrical current passes from one electrode near the tissue to be treated to other fixed electrode (Indifferent electrode) elsewhere in the body --Usually this type of electrode is placed in contact with buttocks or around the Leg

15. - MONO-POLAR DIATHERMY --Active electrode is on surgical site. Patients return electrode is in electrical plate attached elsewhere in the body. Current flows through the patient and localized heating is at the Tip of instrument which is in surgeons hands. Minimal heating on the plate as it has more surface area

16. - MONO-POLAR DIATHERMY

17. -BI POLAR DIATHERMY --Bipolar, where both electrodes are mounted on same pen like device and electrical current passes only through the tissues being treated. --Advantages of Bipolar electrosurgery is that it prevents the flow of current through other tissues of the body and focuses current only n the tissues which are in contact with the Diathermy forceps --This is extremely useful in a-Microsurgery and b-In patients with Cardiac Pacemaker

18. - BI POLAR DIATHERMY

19. - BI POLAR DIATHERMY

20. -COMPLICATIONS -EXPLOSION

21. -EXPLOSION --Sparks from Diathermy can ignite any Volatile Anesthetic agent or Gases or Fluid within the theatre. --Alcohol based skin preparation can catch fire if they are allowed to pool around the patient.

22. -BURNS -Faulty applications of the placement of the Indifferent electrodes with Inadequate contact area -Patient being earthed by touching any metal object . -Faulty insulation of Diathermy leads -Inadvertent activity such as accidental activation of “Foot Pedal”

23. -LAP SURGERY --Diathermy of wrong structure because of lack of clarity of vision. --Faulty insulation of any Lap instrument. --Intraperitoneal contact of Diathermy with another metal instrument. --Inadvertent activity while Tip is out of vision of camera --Retained heat in the Tip – touching the bowel

24. -OTHERS --Short circuit instances leading to electrocution with Pacemaker function channeling effects if used on viscus with narrow pedicle(e.g Penis or Testis)

25. THANK YOU