Needle Electrode High-Frequency Electrosurgical Device: Enhanced Precision for Cervical Conization

With the rising rate of HPV infection, the prevalence of cervical intraepithelial neoplasia (CIN), a precancerous lesion of cervical cancer, is showing a younger trend, with more and more women of reproductive age being diagnosed. About 60% of low-grade lesions may resolve spontaneously, while high-grade lesions have cancerous potential and require further diagnosis and treatment.

Treatment options for CIN include conservative and surgical treatments, with surgery being the only effective treatment for persistent CIN. Currently, cold-knife conization (CKC) and loop electrosurgical excision procedure (LEEP) are the most widely used surgical methods for cervical conization.

The CKC procedure use a traditional surgical scalpel to cut tissue. It can remove a sufficiently large and intact cervix at one time for histopathological testing, with clear margins of the resected specimen, without affecting the diagnosis of histopathology. However, intraoperative bleeding is not easy to control, and excessive intraoperative and postoperative bleeding is likely to occur. Moreover, there is a higher incidence of complications affecting subsequent pregnancies, such as cervical adhesion and cervical insufficiency. 

LEEP employs a loop-shaped metal wire (electrode loop) to conduct high-frequency alternating current.It uses the drying and dehydrating effect and arc cutting effect unique to high-frequency electric current to cut the tissues contacted by the loop. The operation is relatively simple and there is a low incidence of complications such as cervical adhesions and cervical insufficiency that may affect subsequent pregnancies. However, the limited depth of cut of the LEEP procedure can lead to a positive histopathological diagnosis of the margins of the resected specimen, forcing the patient to undergo a second operation.

To overcome the limitations of traditional cervical conization techniques, the research team at Guangzhou Women and Children's Medical Center innovatively adopted a high-frequency electrosurgical knife equipped with a needle-type electrode for the procedure. This approach combines the broad excision range and effective intraoperative hemostasis of conventional high-frequency electrosurgery with the unique advantages of the needle-shaped electrode—namely, a smaller cutting surface and reduced thermal damage to the excision margins, thereby minimizing the impact on postoperative pathological results.

Clinical data: Among 60 patients, the postoperative histopathological diagnosis of the excised cone tissue was consistent with preoperative colposcopic biopsy results in 41 cases, yielding a concordance rate of 68.3%. Additionally, in 15 patients, the postoperative pathology grade was lower, and in 4 patients, higher, than the preoperative biopsy grade. Importantly, all excision margins were negative, with clear edges and no carbonization from electrocoagulation observed.

Conclusion: The use of a needle-type high-frequency electrode in cervical conization ensures adequate excision range and hemostasis without compromising margin pathology. Furthermore, the postoperative incidence of pregnancy-related complications such as cervical insufficiency, premature rupture of membranes (PROM), and preterm birth remains low.

ShouLiang-med is committed to offering a diverse range of high-frequency surgical instruments, including various needle-type electrodes. These instruments are clinically recognized for their premium materials, anti-adhesion properties, and precise cutting and coagulation performance. Looking ahead, ShouLiang-med aims to empower healthcare providers worldwide with more efficient surgical solutions and help build a safer treatment environment for patients globally.

Reference:

Chen Rui, Qiu Ting, Yi Lisha, Guo Zhiliang, Yi Danni, Cai Chunfang, Ji Bing. Clinical Application of Needle Electrode–High-Frequency Electrosurgical Knife in Cervical Conization. Modern Hospital, 2023, 23(12).