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Electrosurgical Units: Misconceptions, Repairs, PMs, and Cost-Saving Tips - ReNew Biomedical

Originally published in Technation, Expert Advice, April 2022.

Josh Weatherford, ReNew Biomedical’s Electrosurgical expert, answers FAQs about maintenance, service, and money-saving tips for ESUs.

Q: What steps can a facility take to increase the lifespan of its Electrosurgical unit?
Weatherford: An ESU’s lifespan can be prolonged by adhering to the directions for use outlined in the operation manual. For example, most ESUs specify a 10 second cut time, followed by a 30-second rest time. This interval allows the unit’s circuitry to cool after delivering the intense energy required to produce an output.1t2a9380 - ReNew BioMedical

Another easy way to achieve a longer lifespan for any electrical equipment is routine cleaning. Dust buildup alone can cause units to operate at a hotter temperature due to reduced airflow inside the unit.

Routine maintenance will also prolong the life of an ESU. Regular maintenance will thoroughly test the unit against the manufacturer’s specifications and identify any issues or potential future issues. It’s also a great opportunity to fully clean the unit. Here at Renew Biomedical, each unit receives a detailed cleaning during maintenance or repair at no additional charge.

Q: What are some cost-saving tips for ESUs?
Weatherford: The best way to save money regarding ESUs is to be gentle. Mishandling of the units causes many of the repairs we perform at Renew. ESUs are particularly delicate. A hit to the nosecone can cause many internal issues that result in the unit no longer functioning. The unit is also easily damaged from falls. I recommend careful handling of ESUs in transport as well as storage. Additionally, there are aftermarket support options for ESUs should your facility need outside repairs or PM services.

Q: How are newer ESUs improving over the old versions?
A: Newer ESUs are receiving more technology integration. They are “smarter” and faster than their predecessors. For example, the older Valleylab Force FX had a sampling rate of 200 samples per second using Instant Response technology. At the time, 200 samples/second was cutting edge. However, the newest Valleylab model, the FT10, boasts a sample rate of 434,000 decisions every second.

Technology integration also helps the Biomed community. These “smarter” units are better able to generate error codes and identify the issues they are experiencing. In some cases, the unit can even diagnose the error. This aids the biomed by expediting the repair process. The unit’s advanced self-testing also gives an additional repair verification once repaired.

Q: What are some steps for Preventive maintenance, and why are PMs important for ESUs?
Weatherford: Preventative maintenance (PM) is vital for any medical device, and ESUs are no different. A typical PM inspection would follow the manufacturer’s testing process outlined in the service manual. The most important tests in a PM are output testing, REM function testing, and leakage testing.1t2a9398 - ReNew BioMedical

The biomed will activate the unit during output testing and observe the energy delivered to a calibrated ESU analyzer. The tech will then record this measurement and compare it against the manufacturer’s acceptable energy range.

REM function testing is another critical test. The REM function, or Return Electrode Monitor, provides a complete pathway for energy flow from the ESU to the patient. A fault with the REM circuit could cause the ESU to have no Monopolar function, potentially causing harm to the patient.

Leakage testing measures the leakage produced by the ESU during use. This measures energy not being delivered through the handpiece and could be dangerous if the leakage is outside acceptable ranges.

Q: Are there any commonly missed steps that often get overlooked in PMs?
A: The most overlooked part of the manufacturer’s service recommendation is the service interval. Most manufacturers recommend their products have output testing done every six months. Instead, most units are checked annually. Unit calibration should occur anytime the outputs are measured outside the service manual’s parameters. The unit will not pass the manufacturer’s PM criteria if the outputs are outside the acceptable range.

Q: Are there any common biomedical misconceptions about ESU devices?
A: Electrosurgery is often misunderstood in the biomedical field. Many techs feel that ESUs are incredibly dangerous and difficult to understand. ESUs can be dangerous; however, every modern ESU has many safety measures designed to mitigate most risks. For example, the Monopolar function will not activate if the REM circuit does not provide the correct feedback resistance.

ESUs are complex machines, but they rely on basic principles of electricity for function. To understand how an ESU works, one has to understand the way electricity behaves.

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