Fulguration

Overview

Fulguration, which includes electrofulguration and electrocoagulation, is a type of electrosurgery based on the ancient principle that heat can heal. Electrosurgery uses high-frequency electrical currents from an electrosurgical generator to target specific cells, such as those forming benign or cancerous tumors. These electrical currents pass through the skin and increase the cells’ internal temperature, leading to their destruction.

In electrosurgery, the skin does not conduct electrical energy, so the electrical currents continuously raise the internal temperature of the target cells. When the cells’ internal temperature reaches 140 degrees Fahrenheit (60 degrees Celsius), they die instantly. If the temperature rises to 194 degrees Fahrenheit (90 degrees Celsius), the cells dry out, and at 212 degrees Fahrenheit (100 degrees Celsius), the cells vaporize. The procedure involves using a specialized tool to direct the electric currents toward the target cells, and patients are given anesthesia to prevent them from feeling the electrical currents or the generated heat.

Fulguration operates on the same principle as electrosurgery, but without making direct contact between the electrical current and the skin. Instead, healthcare providers hold a probe over the skin to create a spark that generates enough heat to kill the targeted cells. Sometimes, they use tiny wire loops carrying electrical currents to generate heat, which removes growths and stops bleeding.

Types

The following types of electrosurgery includes:

• Electrodessication: The process of electrodessication involves drying out tissue and destroying abnormal cells.
• Electrocoagulation: Results in a clot in blood vessels that are bleeding.
• Electrosection: A tissue-cutting procedure.

Reasons for undergoing the procedure

Fulguration is a medical procedure employed by healthcare providers to remove growths or abnormal cells from both internal and external areas of your body. These growths can range from benign conditions like condyloma (genital warts) or endometriosis to potentially cancerous or precancerous ones such as actinic keratosis, which can progress to squamous cell carcinoma.

Here are a few condition that the healthcare provider utilizes fulguration:

• Skin cancer or other skin conditions.
• Bladder cancer.
• Cervical cancer.

Risk

Fulguration and other electrosurgery that has a few particular risks. Healthcare providers who utilize fulguration get specialized training with an emphasis on reducing risk. Among the risks are:

• Potentially harmful electrical shocks to both you and your healthcare providers.
• Burns caused by heat or electricity from explosions or fires. Healthcare providers take precautions, such as using nonflammable cleaners and making sure you don’t come into contact with any metal while having the procedure.
• Toxic gas-related infections. Surgical smoke and aerosolized blood droplets during electrosurgery have the potential to spread bacteria, viruses, and diseases. Healthcare providers protect themselves from toxic gases by using surgical gloves, face masks, smoke-evacuation systems, and protective eyewear.

Before the procedure

Prior to the scheduled procedure, the healthcare provider will conduct the following:

• Your healthcare provider will explain how fulguration works and why they recommend using it to treat your specific medical condition.
• The majority of fulguration treatments are performed as outpatient procedures. Your healthcare provider will advise you on what to do the day of your procedure because fulguration is utilized differently for different procedures.
• Prior to the procedure, you will be given either a general, regional, or local anesthetic.

During the procedure

This is what your fulguration process may consist of:

• On an examination table, you will lie down so that healthcare providers can place a pad over your body. Electric currents can be moved from your body back to the source using the electrodes on the pad.
• To obtain electrical current, healthcare providers utilize electrosurgical generators that are specifically engineered. High-frequency, short-wave currents are modulated or set for the generator.
• Through two conduits or cords, electrical currents are sent and received by the generators. The instrument or tip that delivers electricity to your body has a single cord attached to it. The return electrode on your body is connected to the other cord.
• Electrical currents from the generator flow through the instrument or tip and onto your body’s return electrode.
• The instrument or tip stays off your body during fulguration. Rather, the instrument or point produces a spark that, in time, warms your body to a temperature that destroys the targeted growths. (During a cystoscopic fulguration, the treatment area is touched by the instrument.)
• After that, the currents leave your body and go back to the electrosurgical generator via the return electrode.

Fulguration has various applications in the diagnosis and treatment of bladder conditions, such as bladder cancer and cervical pre-cancer and cancer.

• Fulguration of bladder cancer: Healthcare providers utilize fulguration following tissue removal for examination during bladder surgery. Anesthesia is administered to you prior to this treatment.

To access your bladder and remove cancers without creating incisions, healthcare providers use a rigid device called a resectoscope. An electrical current can flow through a tiny wire loop on the resectoscope. In order to eliminate any remaining cancer cells and stop bleeding, the healthcare providers will surgically remove your tumor and burn the tumor site using the loop.

• Fulguration in cervical surgery: To eliminate abnormal cells from your cervix, healthcare providers use fulguration. A speculum is usually gently inserted into your vagina during cervical surgery to allow your surgeon to view your cervix. With the speculum, the healthcare provider guides a thin, electrically charged wire loop to your cervix after injecting or applying a numbing medicine. A thin layer of tissue harboring abnormal cells is sliced when the loop is passed over the cervix.

After the procedure

Depending on the specific medical need, various procedures may be employed for fulguration. Typically, anesthesia is administered during the procedure. Afterward, you will require some recovery time before being discharged from your healthcare provider’s office or facility, similar to any surgery involving anesthesia. Throughout your recovery, your healthcare provider will provide guidance on post-procedure care and what to expect.

Outcome

Fulguration is a minimally invasive surgical technique used by healthcare providers to treat diseases without large incisions or cuts. It is employed for diverse treatments, including removing benign growths from the cervix, malignant tumors from the bladder, and treating skin cancers. Recovery periods vary for each procedure. Before starting, discuss with your healthcare provider what to expect afterward.

Seek medical attention if you experience any of the following:

• Fever above 101 degrees Fahrenheit (38.3 degrees Celsius).
• Unusually heavy bleeding from your incision site.