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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 CT

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