Bipolar uses lower voltages so less energy is required. But, because it has limited ability to cut and coagulate large bleeding areas, it is more ideally used for those procedures where tissues can be easily grabbed on both sides by the forceps electrode. Electrosurgical current in the patient is restricted to just the tissue between the arms of the forceps electrode. This gives better control over the area being targeted, and helps prevent damage to other sensitive tissues. With bipolar electrosurgery, the risk of patient burns is reduced significantly.In the most common techniques, the surgeon uses forceps that are connected to the electrosurgical generator. Monopolar can be used for several modalities including cut, blend, desiccation, and fulguration. Using a pencil instrument the active electrode is placed in the entry site and can be used to cut tissue and coagulate bleeding. The return electrode pad is attached to the patient, so the electrical current flows from the generator to the electrode through the target tissue, to the patient return pad and back to the generator. Monopolar electrosurgery is the most commonly used because of its versatility and effectiveness.
