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Electrosurgical units (ESUs) designed with monopolar and bipolar capabilities that can also provide controlled delivery of energy and physical pressure to perform autologous tissue fusion. These units consist of a central unit (i.e., console) that houses a radiofrequency (RF) generator that delivers the RF power to the tissues through appropriate cables and electrodes permitting its operation as a conventional monopolar/bipolar electrosurgical unit. In addition, these ESUs include a feedback system that senses and accurately controls the delivery of energy to the tissues simultaneously with the application of pressure when performing tissue fusion (i.e., sealing). A variety of dedicated detachable tools is available for use as electrodes that also apply the required physical pressure. The fusion mechanism is mainly used to fuse blood vessels; it is based on the formation of an autologous seal (i.e., sutureless) in the vessel walls by melting the collagen and elastin. Tissue fusion is usually possible for vessels up to 7.5 mm (0.3 inch) diameter. The seal obtained in the procedure usually has a similar bursting strength (i.e., the pressure required to rupture the vessel) as a sutured seal. The unit may also seal lymphatic vessels and some tissue bundles. Electrosurgical units with tissue fusion capabilities are intended for both open surgery and laparoscopic procedures. They may also be used for hemostasis in difficult procedures such as those performed on the infant and child vasculature and in sutureless surgery for hemorrhoids (i.e., hemorrhoidectomy). They are also used in a variety of specialties (e.g., ophthalmology, dermatology, otolaryngology, gastroenterology, urology).
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