Advancements in Technology Increasing Usability/Application of Electrosurgical Devices
The application of electrosurgery devices has expanded significantly to include a wide variety of surgical specialities mainly due to its advantages such as the ability to make precise cuts with limited blood loss. Electrosurgery employs devices, where electrical energy is used to achieve a desired clinical effect in which a radio-frequency (RF)/ alternating current, is passed through the tissue to cut, coagulate, desiccate, or even to fuse tissue. In electrical cauterisation direct current is used to make tissue cuts whereas in electrosurgery alternating current is used. The main advantage of using electrosurgical devices over electrocautery devices is that they reduce damage to the surrounding tissues as these devices are highly precise, where the Low voltage is preferred for cut modes and a high voltage is preferred for coagulation mode.
Electrosurgery is commonly used in dermatological, gynaecological, cardiac, plastic surgery, ocular, spine, ENT, maxillofacial, orthopaedic, urological, neurological and general surgical procedures as well as certain dental procedures. It has been in use from decades and has some complications, including thermal injuries to non-targeted tissues, burns, electric shock, transmission of infection and production of toxic gasses, etc., due to break or defect in the insulation of the instrument’s coat. There is also the risk of temporary or permanent nerve damage and scarring associated with the use of electrosurgical devices. Hence, the adverse effects of electrosurgical devices are leading to the innovation of alternatives such as ultrasonic energy and laser treatments.
Recent advancement in electrosurgical devices includes argon enhancement systems that have enabled a new element of precision and control in electrosurgical applications with benefits that includes quick and efficient coagulation, a thinner, less charring and less tissue damage. In addition to argon-enhanced coagulation systems, Medtronic started offering the Valleylab argon gas delivery system II which offers argon-shrouded cut and creates less surgical smoke than conventional electrosurgical cutting and enhances surgical visibility. The introduction of new Helium based plasma system lowers the risk of injury to surrounding tissue, and less smoke during the electrosurgical process and focuses on RF energy for greater control of tissue effect, enabling a high level of precision and virtually eliminates tissue trauma. Additionally, the newer advanced smoke evacuation system filters the surgical smoke (plume) to remove odour, particulates, and other potentially hazardous by-products of electrosurgery procedures as the exposure to plume poses health risks for surgeons, nurses, as well as patients. For instance, Medtronic is offering the RapidVac smoke evacuator system, designed to filter the surgical smoke that contains toxic chemicals, viable bacteria, viruses, and mutagenic substances. The electrosurgical generators used today are with closed – loop control loops to adjust the voltage and current to maintain the constant output power, as the active monopolar electrodes move through tissues of varying impedance. These adaptive generators are major improvements over traditional electrosurgery.
The advancements in electrosurgical procedures includes minimally-Invasive procedures such as laparoscopic and robotic-assisted surgery which are becoming popular globally as they offer the better clinical outcomes than open surgical procedures as they offer better clinical outcomes than open surgical procedures. Some of the disadvantages of the use of electrosurgery devices is a high risk of thermal injury. Hence, to overcome the issue of electrosurgical burns in minimally invasive surgery, the manufacturers are focusing on burn protection system which works with electrosurgical units and helps in the reduction of complications of stray energy burns. For instance, Intuitive offers an EndoWrist Vessel Sealer and the Erbe VIO DV electrosurgical generator. It is a bipolar electrosurgical instrument intended for use with the da Vinci Xi Surgical System which is proposed for grasping and blunt dissection of tissue and for bipolar coagulation and mechanical transection of vessels up to 7 mm in diameter and tissue bundles that fit in the jaws of the instrument. The Vessel Sealer is intended for use only with the da Vinci-configured Erbe VIO DV generator. The use of the Vessel Sealer with other generators could result in injury to the patient or cause damage to the instrument. and also in May 2016, – Encision, a U.S. based surgical instruments company started offering the new AEM EndoShield Burn Protection System, a plug and play a smart card that interfaces with electrosurgical generators and helps in eliminating the stray energy burns. The plug and play cord of end shield 2 enables any standard electrosurgical generator to easily provide advanced levels of patient safety in laparoscopy with Encision`s Active Electrode Monitoring (AEM) technology and these systems can be used in a number of surgical procedures without reprocessing. Hence, the burn protection system provides greater flexibility to perform laparoscopic procedures with electrosurgical generators.
According to IQ4I analysis, the electrosurgical devices global market is expected to grow at a CAGR of 5.6% to reach $6,178.2 million by 2023. The global electrosurgical devices global market is progressing at a moderate rate due to increase in the number of patients suffering from obesity, the rise in ageing population, increasing demand for minimally invasive procedures, growing preference for cosmetic surgery procedures and advancements of technologies are driving the growth of the electrosurgical devices global market. However, the risks and complications associated with electrosurgery, product recalls, healthcare reforms, especially in U.S., preference for non-invasive procedures and pricing pressure on medical device manufacturers are restraining the growth of the electro surgical devices global market. Geographically, developed regions of North America followed by Europe dominates in revenues, however, Asia-Pacific region is propelling with fast growth due to increase in healthcare spending and advancements in healthcare facilities.
Some of the major companies operating in the electrosurgical devices market are B. Braun Melsungen AG (Germany), Bovie Medical Corporation (U.S.), Bowa Electronic GMBH & Co. KG (Germany), Conmed Corporation (U.S.), Medtronic (Covidien) (Ireland), Erbe Electromedizin GMBH (Germany), Johnson & Johnson (Ethicon) (U.S.), Olympus Corporation (Japan), Smith & Nephew PLC (U.K.), Symmetry Surgical Inc. (U.S.), Utah Medical Products Inc. (U.S.)., are considered to be the leaders in this space with their marketed products and strong pipelines. Some of the emerging players in electrosurgical devices are UZUMCU (Turkey), Telea electronics engineering (Italy), Symmetry surgical (U.S), Olives (India), Applied Medical (U.S.), Atricure (U.S.), Stryker (U.S.), Arthrex (U.S.), Depuy Synthes (U.S.), Wisap medical technology (Germany), SKLAR (U.S.), Richard Wolf medical instruments corporation (U.S.), Maxer (Germany), Etc.,