Understanding Bipolar Cautery Pencil: Components, Usage, and Precautions

Table of Contents

Introduction: Understanding Bipolar Cautery Pencil

The field of medicine and surgery has witnessed remarkable advancements in technology over the years, leading to the development of various instruments and tools that aid healthcare professionals in providing effective treatments. One such instrument that has gained significant importance in surgical procedures is the bipolar cautery pencil.
A bipolar cautery pencil is a handheld device used in a variety of medical settings to perform tissue coagulation, cutting, and cauterization. It is designed to deliver electrical current directly to the target tissues, allowing for precise control and finer surgical outcomes. This versatile tool finds application in a wide range of surgical procedures, assisting surgeons in achieving hemostasis and ensuring optimal surgical outcomes.
In this comprehensive guide, we will delve into the components and working mechanism of a bipolar cautery pencil, explore its various applications, provide detailed instructions on how to use it correctly and highlight essential precautions to ensure safe and effective operation. By the end, you will have a thorough understanding of the role of a bipolar cautery pencil and its significance in the medical field. So let us embark on this journey to gain insights into the functionalities and potential of a bipolar cautery pencil, equipping ourselves with the knowledge required for safe and effective utilization in surgical procedures.

What is bipolar cautery pencil?

A bipolar cautery pencil, also known as bipolar electrocautery or simply bipolar cautery, is a medical instrument used in surgical procedures for precise tissue coagulation and hemostasis. It is a type of electrosurgical device that uses high-frequency electrical current to generate heat and coagulate tissues, preventing bleeding during surgery.
Unlike traditional monopolar cautery, which requires a separate disposable grounding pad and can pass electrical current through the patient’s body, bipolar cautery functions without the need for a disposable grounding pad. Instead, the cautery pencil has two tips (hence “bipolar”), both of which are active electrodes. The electrical current flows only between these two tips, allowing for localized coagulation and reducing the risk of unintentional damage to surrounding tissues.
Bipolar Cautery Pencil

Components of bipolar cautery pencil

  • Host(Electrosurgical Unit)
  • Bipolar forceps
  • Foot control switch
No need for disposable grounding pads.
There is a single-function host only for bipolar cautery pencil, as well as a combined host is also used in conjunction with a monopolar cautery pencil.

How does bipolar cautery pencil work?

The electrosurgical unit is an electronic radio frequency current generator. The bipolar forceps have good contact with the tissue. The current passes between the two poles of the bipolar forceps, and the deep condensation spreads radially, and the related tissue becomes light brown small eschar. It will not form a significant arc. Good coagulation effect can be achieved in dry or wet surgical fields. Since a loop has been formed between the two poles of the electrode, there is no need to use a disposable grounding pad.
  • Working and circuit electrodes are on the device
  • Current flows only through the interelectrode tissue
  • Bipolar cautery pencil basically has no cutting function, mainly coagulation function, and the coagulation speed is slow, but the hemostatic effect is reliable and has little effect on the surrounding tissue.
02 How does bipolar cautery pencil work

What is a bipolar pencil used for?

Bipolar cautery pencils are often used in delicate surgical procedures, such as neurosurgery, ophthalmic surgery, and laparoscopic surgeries. They are particularly useful in areas where precise control is essential, as they offer a more controlled and focused application of electrical energy compared to monopolar cautery. The device is commonly found in modern operating rooms and is an essential tool for surgeons in various specialties.
It is also suitable for patients with pacemakers, while a monopolar cautery pencil can not be used.

How to use bipolar cautery pencil

  1. Connect the power supply, connect the foot pedal, and place it under the foot of the surgeon.
  2. Power-on self-test, set the output power according to the requirements of the operation.
  3. Connect the bipolar coagulation plug.
  4. After bipolar forceps clamped tissue or bleeding point, step on the pedal to coagulate&hemostasis, and then release the pedal.
  5. After use, turn off the power switch of the host first, and then unplug the power plug.

Precautions when using bipolar cautery pencil

Select the appropriate bipolar forceps and output power

The range of action of bipolar electrocoagulation on tissue depends on two factors: the current density passing through the unit tissue and the surface area of the bipolar forceps in direct contact with the tissue.
Therefore, in order to not only effectively break a certain structure, but also avoid unnecessary damage to other tissues to the greatest extent, the tip of the forceps with a width of 0.3 to 1.0 mm should be selected according to the surgical site and tissue properties, and the electrocoagulation output power generally does not exceed 4W; When the load is 100 ohms, it should be less than 22W

Rinse with normal saline continuously during use

The purpose is to keep the tissue moist and tension-free; keep the surgical field clean; avoid high temperature affecting the surrounding important tissues and structures; reduce the adhesion of tissue eschars to electrocoagulation forceps.

Each coagulation time is about 0.5 seconds

it can be repeated many times until the coagulation effect is achieved. Intermittent coagulation can effectively prevent the adhesion of forceps to tissue or eschar than continuous coagulation to avoid damage.

Remove the eschar on the bipolar forceps in time

erase the eschar on the bipolar forceps with wet gauze or special non-destructive cloth, and do not scrape with a sharp device, otherwise, it will damage the silver-copper alloy at the tip of the forceps.

Keep distance for tips of forceps

The two tips of the forceps should be kept at a certain distance and should not be in contact with each other to form a short circuit of the current and lose the coagulation effect.

Control the output of coagulation

When electrocoagulation near important tissue structures (such as brainstem, hypothalamus, etc.), the coagulation output should be as small as possible.

Cover the foot pedal board

The pedal control board should be covered with a waterproof plastic cover before use, to prevent blood and rinse fluid from wetting the pedal control board during the operation and making it difficult to clean, or causing circuit failure or short circuit.

Safe use of forceps

The tip of the forceps is intricate. When using, cleaning and placing, pay attention to protecting the tip of the forceps, put on a protective cover, and do not stack them with other heavy objects.
Safe use of bipolar forceps

Sterilization of forceps

Preferred disinfection with ethylene oxide Or by high temperature and high pressure disinfection (below 135 degrees Celsius) Before disinfection, rinse the forceps with clean water and dry them! Avoid pressure on forceps during sterilization
Prohibited: fumigation with glutaraldehyde and formalin.

Suggestions when using forceps

Use two forceps alternately
Wipe gently with wet gauze when the tips of the forceps are sticky
Do not use electrode tip cleaner to wipe!


Understanding the function and application of a bipolar cautery pencil is critical for healthcare professionals. The device improves surgical precision, reduces blood loss and promotes faster recovery.
However, the importance of using bipolar cautery pens safely to avoid complications must be emphasized. Following guidelines, maintaining instruments and prioritizing patient safety are key. Healthcare professionals should continually update their knowledge and skills in using this instrument. By mastering its use, surgical outcomes can be optimized, patient morbidity reduced, and overall patient care improved.

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