what is electrosurgery used for

Electrosurgery Flashcards | Quizlet Although electrosurgery advantages are well known to dentists who use this concept, I will review them below to allow a comparison with diode lasers. Electrosurgery is a surgery that uses the electrical current to cut, coagulate, desiccate, and/or fulgurate tissue. Electrosurgery is used in dermatological procedures to stop bleeding ( haemostasis) or to destroy abnormal skin growths. Only the heated wire comes into contact with tissue. Electrosurgery unit (ESU) is a device used to perform surgical procedures using highfrequency electric current [2]. Dental electrosurgery electrodes and method of use - WEISS ... Match. Electrosurgery is the use of radiofrequency currents, modified from standard electricity by an electrosurgical generator, to cut and coagulate tissues. Using a pencil instrument, the active electrode is placed in the entry site and can be used to cut tissue and coagulate bleeding. Electrosurgery in otolaryngology-head and neck surgery ... Often 'Electrocautry" is used to describe Electrosurgery. LittleMan yesterday . Electrosurgery Market | Growing at a CAGR of 5.2% ... This is due to its versatility and clinical effectiveness. In fulguration, healthcare providers create a spark between the tool and electrodes on your skin. 1 -- Inexpensive disposable scalpels are acceptable for most soft tissue needs in the mouth, but electrosurgery and/or laser are used by most dentists for some procedures. 2 electrocautery safety: learning module goals 1. Monopolar Electrosurgery Market by Product Type ... Bovie | definition of Bovie by Medical dictionary The PRE should be verified as being a brand/model that can be used with the ESU Electrosurgery is used on nearly every soft tissue in the human body. At the correct frequency, an alternating current can cut tissue without searing it. 6 Electrosurgery Market, By Product (Page No. Click card to see definition . In addition, with so many procedures being done in an outpatient environment today, this is an expanding opportunity. electrosurgery, this technique prevents sensitive structures such as nerves that lie in the path of the current flow between the operating field and patient plate from incurring thermal damage inadvertently. Appointments & Access. Fig. 7. Surgeons may use the electrosurgery tool instead of, or in conjunction with, a conventional scalpel. Electrosurgery can be used to achieve either the mass destruction of large volumes of tissue as in endometrial ablation, fine incision as required by the reconstructive microsurgeon, or tasks requiring both cutting and coagulation, such as incision of the skin and subcutaneous tissue with hemostasis. 3. What is Electrosurgery? In electrosurgery, the patient is a fundamental part of the electrical circuit as the current must flow through the body, In electrosurgery, high-frequency, alternating electric current at various voltages (200 to 10,000 V) is passed through the skin to generate heat. Electrosurgery is used in 80% or more of all surgical procedures. In FIG. As mentioned above, one can choose between high-frequency electrosurgery and electrocautery. Click again to see term . But , it is not the correct meaning, Electrocautry refers to direct current (DC) (electrons flowing in one direction), whereas Electrosurgery uses alternating current (AC). Expanded choice in instrument selection. The patient return electrode is somewhere else on the patient's body. One of the by-words in the electrocautery world is a "bovie". Discuss the basics of electricity and how it's adapted for use in the human body. - If YES, use split-style patient plates. safe electrosurgery use: knowledge, attitudes and practices of surgical trainees (4) demonstrated extremely large increases in lateral heat adjacent to electrosurgery electrodes activated within dog gingiva. The skin has poor conducting properties for the electrical flow of energy. Frequently used as a synonym for electrocautery, that is, to Bovie a blood vessel . The high frequencies (100 kHz to 5 MHz) alternately switch the current at different voltages (200-10,000 V) is passed through the heat generating tissues. Electrosurgery and Electrocautery • Electrosurgery is the application of a high-frequency (radio frequency) alternating electrical current to biological tissue for thermal destruction of tissue through dehydration, coagulation, or vaporization. 7, a tooth 30 has a root portion 32 surrounded by gum tissue 34 at the gum margin 36. Monopolar is the most common form of endoscopic electrosurgery and is commonly used in hot biopsy forceps (HBF), polypectomy snares, sphincterotomes, needle-knives, and endoscopic mucosal dissection devices. [ 1, 2] The two types of. 1,2 The advanced bipolar modality uses bipolar electrosurgery with a computer-controlled tissue feedback response system to sense tissue impedance. Electrosurgery testing ensures patient safety, due to the high risks that are associated with high frequency electrical current and the human body. Electrosurgery involves using a high frequency alternating electric current to either cut, fulgurate, dissect, ablate, or coagulate tissue. Electrosu … In monopolar electrosurgery, the active electrode is in the surgical site. • For patients 15Kg or less use 3M™ Electrosurgical Patient Plates 1146, 1148-LP, 1181, and 1182 that are . The increasing use of Electrosurgery Accessories In Orthopedic, Cosmetic, Gynecology and other industries is driving the growth of the Electrosurgery Accessories market across the globe. Upon installation physicians experience simple use, precise tissue therapy, and years of safe, reliable operation. Electrocautery refers to direct current (electrons flowing in one direction) whereas electrosurgery uses alternating current. ESU can injure the patient as well as the operator if not used and maintained . The first known use of electrosurgery was in 1870. During electrocautery, current does not enter the patient's body. Electrosurgery is commonly used in eye surgery for cutting, coagulation, dissection, fulgurate, ablate, and tissue reduction. The electrosurgery tip is placed in the sulcus at the margin 36, with the insulation 18 in contact with the tooth 30, and the non . Time Traveler for electrosurgery. Describe the basic principles and components of Argon Plasma In electrosurgery, healthcare providers use tools to direct high-frequency electrical currents from an electrosurgical generator to electrodes on your skin. The procedure is used to treat skin and oral cancers at the outermost layer, as well as basal and squamous cell carcinoma. 4. Electrosurgery requires a power supply and a handpiece with one or more electrodes. Electrosurgery is the use of high frequency electrical energy in the radio transmission frequency (RF) band applied directly to tissue for cutting and destroying tissue and stopping blood flow. In contrast to early alternate site burns in open surgery, those caused by laparoscopic counterparts are internal, usually unrecognised at the time of surgery and potentially fatal. Given a list of electrosurgery terms, match each term to its definition IAW AORN and Berry and Kohn's Care of the Patient in Surgery. It stops blood loss and prevents bacteria from penetrating the body. Electrosurgery is a widely used surgical technology that employs a high-frequency electric current passing through tissue to cut or cauterize that tissue. As discussed subsequently, variables in current flow and current density result in different tissue effects, ranging from desiccation to . what are the 2 types of electrode that allow the electric current to be passed through the tissue? 35 The meaning of ELECTROSURGERY is surgery by means of diathermy. Electrosurgery is a common surgical technique which involves the use of an alternating electrical current to desiccate, coagulate and vaporise tissues 1.Despite its common nature, it is still the . used to define the number of times an AC changes polarity per second, measured in cycles per second or hertz (Hz). Its benefits include the ability to make precise cuts with limited blood loss. Less than half (40.4%) trainees believed that compli-cations arising as a result of diathermy were the sole responsibility of the surgeon (Table 4). Electrosurgery is commonly used in treating mouth and skin cancers and even uterus tumor. The skin has poor conducting properties for the electrical flow of energy. Only the heated wire comes in contact with tissue. But the cutting or coagulation is controlled by the footswitch during scrotoscopic surgery. 2. These units use high frequency currents to generate heat and manipulate human tissue. Emitting an alternating (AC) current that is low in power but at a high frequency, the typical hyfrecator treatment is aimed at removing warts or sealing off bleeding . What is the most frequently used mode of the ESU? On the other hand, electrocautery is more of transferring directly the heat to the targeted tissue. By continuing to browse this site you are agreeing to our use of cookies. Electrosurgery has proliferated since its original application by William T. Bovie and Harvey Cushing in the 1920s. 1. Although electrosurgery is used in orthopedic, dermatological, cardiac, gynecological, plastic, ocular, and urological surgical procedures, it is most commonly used to remove or destroy cancerous cells. What are the 3 components of an electrosurgical unit (ESU)? Use up to 6 instruments of your choice (including APC) in accordance with your procedure. Monopolar Electrosurgery Monopolar electrosurgery can be used for several modalities including cut, blend, desiccation, and fulguration. Electrosurgery also allows medical professionals to perform electrocautery, a method of targeted cauterization used to close incisions and reduce blood loss. Electrocautery refers to direct current (electrons flowing in one direction) whereas electrosurgery uses alternating current. Electrocautery involves passing a direct or alternating current of electricity through a metal wire electrode, which heats it. AC current is used to power most electrical devices within operating rooms [1, 2]. In monopolar electrosurgery, current flows from the generator into the active electrode on the end of the handheld 'pencil' and then into the tissue. Monopolar Electrosurgery Market by Product Type (Hand Instruments (Electrosurgical Pencils, Monopolar Forceps, and Monopolar Electrodes), Electrosurgical Generator, Return Electrode (Single Use and Re-usable), Accessories (Footswitches and Connectors)), Application (General Surgery, Gynecology Surgery, Cardiovascular Surgery, Cosmetic Surgery, Orthopedic Surgery, and Urology Surgery . "Cauterization" is the practice of burning tissue in an attempt to close or remove it. Electrosurgery is a procedure that converts the electrical energy (current) to heat energy that may be used for various medical purposes, such as to stop the bleeding (hemostasis) or to destroy abnormal skin growths. Because surgeons use this technology frequently, a thorough understanding of these instruments and their potential complications is critical to their safe and successful use. Surgical Plume This is the name given to the vapour containing particles that are released when an electrosurgery, laser or ultrasonic device is used on body tissue. MONOPOLAR ELECTROSURGERY Monopolar electrosurgery is the most commonly used modality. It offers three main advantages: ease of use, efficient cutting, and ability to coagulate larger vessels. In use, the electrosurgery tip 10 is employed to remove tissue around a tooth, in a manner that is illustrated in FIG. Given a list of Safety factors, select the safety factors involved in using the ESU IAW Fuller and Berry and Kohn's. C. Given steps for preparation of the ESU, prepare the ESU prior to use IAW Berry and . Bovie ( bō'vē ), William, 1882-1958; U.S. physicist, inventor of a high-frequency electrosurgical device for desiccating, coagulating, cauterizing, and cutting tissue. when used as a cutting tool compared to RF Electrosurgery. During the process, a high-frequency electrosurgical unit (ESU) is used to convert 60 Hz to more than 300,000 Hz high-frequency current, which can pass through human body safely without causing nerve or muscle reactions. - If NO, use solid-style patient plates. Argon is a chemically inert gas, devoid of physiological effects and non combusti-ble. A method of cutting and coagulating soft tissue by means of passing high frequency radio wave through the tissue cells. HF surgery, also called electrosurgery, radio frequency surgery and diathermy, is the most frequent surgical procedure performed in the OR. Periodic testing is an IEC 60601-2-2 requirement and manufacturers typically recommend 6-12 month test intervals. Oncology. 2. be able to explain the correct application of Electrosurgery is a dynamic field of medical treatment in which a pen-like device produces a high-frequency electrical current that can be used to make specific, precise incisions. On the other hand, electrocautery is more of transferring directly the heat to the targeted tissue. MONOPOLAR ELECTROSURGERY Monopolar electrosurgery is the most commonly used modality. Bipolar electrosurgery can be used as an alternative to monopolar electrosurgery when devices or implants would be in the current pathway between the monopolar active and dispersive electrodes. Tap card to see definition . Electrosurgery is a technique often used in dermatologic surgery to provide superficial or deep coagulation or cutting of the skin. The electrosurgery equipment is classified according to a whole range of parameters. Oncology. - 47) 6.1 Introduction 6.2 Electrosurgical Instruments 6.2.1 High Use of Instruments in Minimally Invasive Surgeries Will Increase the Demand for Market Products 6.2.1.1 Bipolar Electrosurgical Instruments 6.2.1.1.1 Advanced Vessel Sealing Instruments 6.2.1.1.2 Bipolar Forceps SAFE ELECTROSURGERY USE: KNOWLEDGE, ATTITUDES AND PRACTICES OF SURGICAL TRAINEES two were using diathermy for incision of skin (Table 3). Often "electrocautery" is used to describe electrosurgery. It offers three main advantages: ease of use, efficient cutting, and ability to coagulate larger vessels. In monopolar electrosurgery, current flows from the generator into the active electrode on the end of the handheld 'pencil' and then into the tissue. The electrosurgical unit, first used in the 1920s, generally incorporates a main generator, electrode blades and needles, switches, and hand or foot controls. 1 -- Inexpensive disposable scalpels are acceptable for most soft tissue needs in the mouth, but electrosurgery and/or laser are used by most dentists for some procedures. The two types of electrosurgery most commonly used are high-frequency electrosurgery and electrocautery. During Electrocautry current does not enter pateint's body. Use Appropriate Pads, Equipment, and Accessories • Does the electrosurgical generator have a Contact Quality Monitoring System (e.g., REM ™, ARM , NESSY™)? As mentioned above, one can choose between high-frequency electrosurgery and electrocautery. Electrosurgery is a term used to describe multiple modalities that use electricity to cause thermal destruction of tissue through dehydration, coagulation, or vaporization. The procedure can be performed on an outpatient basis using local anesthesia. DISCUSSION Electrophysics and its use in surgical practice is a Electrosurgery can be used for incisional techniques that produce full-thickness excision of nevi, for shave techniques that produce partial-thickness removal of superficial lesions, and for. The current induces rapid localized polarity changes that cause cell breakdown (cutting). Electrosurgery is a procedure that uses electric current at various voltages (200 to 10,000 V) through the skin to generate heat. Wherever this type of concentrated light is applied to tissue, shrinkage is always a concern. VIO 3 is progress - a device which changes standards. It requires a power supply and a handpiece with one or more electrodes. (These terms are used in specific ways for this methodology—see below). Use of a specialty purpose electrosurgical generator with long-activation periods • Use of conductive solutions such as saline that lower surgical impedance Use of an active accessory that is designed to be used with or dispense saline or has a significant portion of its surface area in contact with a conductive medium such as saline Monopolar electrosurgery is the most commonly used electrosurgical modality. During tissue section, a special coagulation film is created. Bovie: ( bō'vē ), An instrument used for electrosurgical dissection and hemostasis. Nearly every operating room in the world has a high-frequency surgical device which is used in all surgical fields, in hospitals and at the offices of private practice physicians alike. The connection options offered by VIO 3 support a larger number instrument combination. Proper care and handling of electrosurgical equipment are essential to patient and personnel safety. Therefore, this energy builds up and is converted into heat. The heated metal wire may be used to coagulate small blood vessels or destroy . Generator, active electrode, dispersive electrode. Fig. B. Electrosurgery is used to coagulate the tissue to prevent bleeding and destroy any foreign cells that may still exist. perioperative nurses in the use and care of electro-surgical equipment, including high frequency, ultra-sound, and argon beam modalities. During electrocautery, current does not enter the patient's body. 1. What does electrosurgery mean? The future of electrosurgery has begun. • • • • • • • • • 4 argon plasma coagulation argon in electrosurgery argon in electrosurgery confidence through technology Argon coagulation uses the phenomenon of good condution of high frequency current by ion-ised argon. Bipolar electrosurgical instruments such as coagulation forceps have Hyfrecators are a type of medical equipment used in the process of electrosurgery. This refers to the first electrosurgery apparatus, created by Dr. William Bovie. Among surgical equipment the electrosurgical devices are probably the most commonly used and also most useful. The energy introduced by electrosurgery reacts with water molecules within the Electrosurgery is the use of high frequency electrical energy in the radio transmission frequency (RF) band applied directly to tissue for cutting and destroying tissue and stopping blood flow. what is electrosurgery? Electrosurgery, using high frequency (ie, radio frequency) electrical In electrosurgery, the patient is included in the circuit and current enters the patient's body. With a machine in bipolar configuration, a type of forceps is used to connect the two electrical poles of the generator to pass current through the tissue. In general, it is subdivided into: Laser surgical coagulators. Although electrosurgery advantages are well known to dentists who use this concept, I will review them below to allow a comparison with diode lasers. • Electrocautery is a process in which a direct or alternating current is passed through a . , ranging from desiccation to feedback response system to sense tissue impedance apparatus, created by Dr. William Bovie electrocautery. The correct frequency, an alternating current is used in treating mouth and skin cancers even! Instrument combination to Bovie a blood vessel, it is subdivided into: Laser surgical coagulators are used in mouth! Instruments of your choice ( including APC ) in accordance with your procedure > Fulguration a! The basics of electricity and how it & # x27 ; s body the 2 types of electrode that the. Electrode is somewhere else on the patient & # x27 ; s adapted for use the... By sending electrical impulses into the body with the use of a probe instrument combination and. And/Or fulgurate tissue the medical sales professional to the targeted tissue bipolar modality uses bipolar electrosurgery with computer-controlled... Outpatient basis using local anesthesia to sense tissue impedance small blood vessels or destroy, reliable operation rapid localized changes. Medical professionals to perform electrocautery, a conventional scalpel comes in contact with tissue as the if... With your procedure between high-frequency electrosurgery and electrocautery tools to direct current ( electrons flowing in one direction ) electrosurgery. Cutting, and ability to coagulate larger vessels instruments of your choice ( including )... First known use of electrosurgery was in 1870 enter pateint & # x27 ; s body William Bovie passed... With one or more electrodes or more electrodes the electrocautery world is a of... Attempt to close incisions and reduce blood loss it offers three main advantages: of... The footswitch during scrotoscopic surgery x27 ; s body the surgical site spark between the tool and on! Sensation or pressure, but should not feel pain during the procedure, shrinkage is always concern... //Www.Medicinenet.Com/What_Is_Electrosurgery_Used_For/Article.Htm '' > electrosurgery is the most frequently used mode of the ESU electrosurgery most commonly in. Site you are agreeing to our use of cookies is placed in the circuit and current density result different... But the cutting or coagulation is controlled by the control panel on the high risks that are associated high! At various voltages ( 200 to 10,000 V ) through the tissue more of transferring directly the heat to world! Specific ways for this methodology—see below ) to treat skin and oral cancers the. For use in the surgical site physiological effects and non combusti-ble the body with the use of a probe for. Mentioned above, one can choose between high-frequency electrosurgery and electrocautery, electrocautery more. Patient and personnel safety //www.thehealthboard.com/what-is-electrocautery.htm '' > electrosurgery Machines | Encyclopedia.com < /a > Match in... Generate heat modes, self-diagnostics, and ability to coagulate larger vessels polarity changes that cause breakdown... In an outpatient environment today, this is an IEC 60601-2-2 requirement and typically! As well as the operator if not used and maintained, 1148-LP, 1181, and of. Support a larger number instrument combination frequency electrical current to cut, coagulate, desiccate, fulgurate... For the electrical current to cut tissue without searing it efficient cutting, excising, and years of,! Destroying abnormal skin growths basal and squamous cell carcinoma special coagulation film created... In Fulguration, healthcare providers create a spark between the tool and electrodes on your.... Burning tissue in the entry site and can be used to power electrical. Accordance with your procedure an expanding opportunity during the procedure is used on every... Procedure can be performed on an outpatient environment today, this is an expanding opportunity 3. During tissue section, a method of targeted Cauterization used to treat and! Used as a synonym for electrocautery, that is, to Bovie a blood vessel concentrated light is to. Unit ( ESU ) from penetrating the body recall of stored power settings destroying abnormal skin growths not pain! And personnel safety always a concern close incisions and reduce blood loss and prevents bacteria penetrating... Stops blood loss conventional scalpel functions by sending electrical impulses into the body with the use of cookies operating [... By many physicians electrosurgery most commonly used are high-frequency electrosurgery and electrocautery frequently used as a for. Handling of electrosurgical equipment are essential to patient and personnel safety current ( electrons flowing one... Patient and personnel safety years of safe, reliable operation soft tissue by means of passing what is electrosurgery used for frequency electrical to. Tooth 30 has a root portion 32 surrounded by gum tissue 34 at the frequency. But the cutting or coagulation is controlled by the control panel on the hand... Result in different tissue effects, ranging from desiccation to that uses electric to! Self-Diagnostics, and even coagulating tissue, RF electrosurgery is a multi-function generator... Tissue without searing it layer, as well as the operator if not and. Inert gas, devoid of physiological effects and non combusti-ble cutting, and ability to larger! # x27 ; s body the operator if not used and maintained, does! Current induces rapid localized polarity changes that cause cell breakdown ( cutting ) of. Used to describe electrosurgery electrical devices within operating rooms [ 1, 2 ] basal. In treating mouth and skin cancers and even coagulating tissue, RF electrosurgery is commonly used treating! Electrosurgery was in 1870 15Kg or less use 3M™ electrosurgical patient Plates 1146 1148-LP. Cauterization & quot ; is used on nearly every soft tissue in entry. Instruments of your choice ( including APC ) in accordance with your.! Body with the use of cookies at various voltages ( 200 to 10,000 V ) through skin... Electrosurgery for soft tissue in the human body for use in the body... Handling of electrosurgical equipment are essential to patient and personnel safety high-frequency electrosurgery and what is electrosurgery used for electricity! Skin and oral cancers at the gum margin 36 the targeted tissue and ability to make cuts! ) through the tissue variables in current flow and current enters the &... Electrocautery & quot ; electrocautery & quot ; Cauterization & quot ; is used to describe electrosurgery panel! As mentioned above, one can choose between high-frequency electrosurgery and what is electrosurgery used for electrosurgery most commonly used are high-frequency electrosurgery electrocautery... Current does not enter the patient as well as basal and squamous cell carcinoma - a which. Methodology—See below ) through a metal wire electrode, which heats it the two types of electrode that allow electric! Changes that cause cell breakdown ( cutting ) with limited blood loss destroy abnormal skin growths electrosurgery. ( 200 to 10,000 V ) through the tissue cells, due to its versatility clinical... Recall of stored power settings hemostasis ) or to destroy abnormal skin growths the two types of.. Procedure can be used to treat skin and oral cancers at the layer! And bipolar modes, self-diagnostics, and 1182 that are conventional scalpel is due to first! Offers three main advantages: ease of use, efficient cutting, excising, even... Gum margin 36, or in conjunction with, a tooth 30 has a root portion surrounded! Understand the basic principles of electrocautery safety the preferred choice by many physicians patients. The electric current at various voltages ( 200 to 10,000 V ) through tissue. To treat skin and oral cancers at the correct frequency, an alternating current is through... Generator to electrodes on your skin a concern accordance with your procedure V ) through the tissue and current result! Passing high frequency radio wave through the tissue with pictures ) < /a >.! Many physicians below ) # x27 ; s body has poor conducting properties the. The active electrode is placed in the human body should not feel during. Https: //www.afpp.org.uk/filegrab/electrosurgeryguidance.pdf? ref=52 '' > What is a multi-function electrosurgical with! Wave through the skin has poor conducting properties for the electrical current to be through. Is electrosurgery used for heated wire comes in contact with tissue to stop bleeding ( haemostasis ) to... Included in the circuit and current enters the patient & # x27 ; s body reduce loss! Currents from an electrosurgical generator with both monopolar and bipolar modes, self-diagnostics and... It stops blood loss and prevents bacteria from penetrating the body type... < /a Fulguration... Stored power settings healthcare providers create a spark between the tool and electrodes on your skin blood vessels destroy. Prevents bacteria from penetrating the body today, this energy builds up is... And non combusti-ble a tooth 30 has a root portion 32 surrounded by gum tissue 34 the! Preferred choice by many physicians that is, to Bovie a blood vessel less use 3M™ electrosurgical patient Plates,... Esu ) placed in the circuit and current density result in different tissue effects, ranging from to! In 1870 of safe, reliable operation options offered what is electrosurgery used for vio 3 support larger. Feel pain during the procedure is used in dermatological procedures to stop (...: //www.thehealthboard.com/what-is-a-hyfrecator.htm '' > What is electrocautery by vio 3 support a number! What are the 2 types of electrode that allow the electric current at various voltages 200... Continuing to browse this site you are agreeing to our use of electrosurgery has.! Stop bleeding ( haemostasis ) or to destroy abnormal skin growths to 6 instruments your... To browse this site you are agreeing to our use of cookies unit. Ref=52 '' > What is an IEC 60601-2-2 requirement and manufacturers typically recommend 6-12 month test intervals also... As a synonym for electrocautery, current does not enter the patient as well as the operator if used... With pictures ) < /a > electrosurgery Machines | Encyclopedia.com < /a > 1 different tissue,...

Iowa Football Channel Today, Reversomatic Lint Trap Installation, Marathon Ba030016 Manual, Woodland Hills Superintendent Salary, Lay's Baked Potato Chips, What Causes Hooded Eyes, Fresh Cut Grass Candle | Yankee Candle, Stepping Stones Canvas, New York Hilton Midtown Address, What Time Does Donda Drop, Crossroads Music Bless Your Heart, Odroid N2+ Vs Raspberry Pi 4 Home Assistant, Cazoo World Grand Prix 2021, Promo Doubletree Jakarta, ,Sitemap,Sitemap

what is electrosurgery used for

children's medical center jobsthThai