Monopolar electrosurgery uses an active electrode in the wound and a separate patient return electrode. The patient return electrode must have good contact with low impedance to avoid burns, and newer monitoring technologies deactivate the system if impedance is too high. Bipolar electrosurgery uses tweezer-like forceps where the tines act as both active and return electrodes, confining the current to grasped tissue and avoiding the need for a separate patient return electrode.

2. MONOPOLAR ELECTROSURGERY
● Most commonly used electrosurgical modality.
● The active electrode is in the wound.
● Patient return electrode is attached somewhere else on the patient.
● 4 components: generator, active electrode, patient, patient return electrode
● Produce variety of tissue effects depending on waveform

3. PATIENT RETURN ELECTRODE
● The only difference b/w active
electrode and patient return
electrode is their relative size
and conductivity
● Surface area impedance can be
increased by excessive hair,
adipose tissue, bony
prominences, fluid invasion,
adhesive failure, scar tissue

4. PATIENT RETURN ELECTRODE MONITORING
TECHNOLOGY
REM contact quality monitoring(RECQM)
-protects patient from pad site burn
-monitor impedance at the patient/pad
interface
-system deactivate if impedance is high
-such electrode can be identified by its
split appearance i.e. two separate areas
and a special plug with center pin.

5. INSTANT RESPONSE TECHNOLOGY

7. BIPOLAR ELECTROSURGERY
The two tines forceps
function active and return
electrodes.
● Only the tissue grasped
is included in circuit.
● No patient return
electrode
● Better hemostasis
● Less thermal injury
● Safer than monopolar