Electrosurgical units are also known as Bovie units. Surgeons use these devices in surgical procedures to cut and coagulate tissue using heat. High-frequency electrical current generates heat. Electrosurgical units (ESUs) can be monopolar or bipolar:

• Bipolar units have both the active and return electrode on one instrument, with the tissue between them.
• Monopolar units pass the current from the active electrode through the patient’s body to the return electrode.

Electrosurgical units can cut tissue, vaporizing the cells using a continuous electrical waveform. They can also use an intermittent high-frequency to coagulate proteins and stop bleeding.

Making a List of Priorities for Choosing an Electrosurgical Unit in 2025

A clinic has many factors to consider when choosing an electrosurgical unit. Some of the pain points for your practice to consider include:

• Budget: Finding affordable electrosurgical machines is often a primary consideration for organizations that are choosing an electrosurgical unit.
• Space: Electrosurgery units can come in a variety of sizes. The amount of space that you have to store and accommodate the machine can influence your options.
• Safety: Electrosurgical units can cause burns, electrical shock, and potentially fire. It is important to ensure that the unit is safe for your space and electrical systems.
• Staff experience: The comfort level of your staff factors into the decision regarding which unit to choose.

This guide gives you reliable information, suggestions, and comparisons on the best electrosurgical units for your practice in 2025.

Why Electrosurgical Units Are Essential in Small Practices

Electrosurgical units are used for a number of surgical procedures. These units are frequently used in dermatological procedures, ENT procedures, gynecological procedures, and other minor surgeries such as toenail removals:

• Dermatologists often use electrosurgical units for procedures. They use these units to remove vascular lesions like pyogenic granulomas. They also remove benign lesions such as skin tags and moles.

Your provider may also use an ESU to treat spider veins or angiomas. It can destroy small lesions and remove skin cancers.

• Gynecologists can use electrosurgical units in the operating room. They can also treat precancerous changes in the cervix. Doctors often use Loop Electrical Excision Procedures (LEEP) to remove cervical dysplasia after abnormal pap smears.
• In otolaryngology (ENT) procedures, electrosurgical units can stop bleeding as well as remove skin lesions.
• Many other specialties may use electrosurgical units in their offices. In the urgent care setting, electrocautery may be used to stop bleeding. Family medicine practices often perform a number of minor surgical procedures. Podiatry practices may use electrosurgical units during toenail removals or other procedures.

Electrosurgical units can improve workflow efficiency by shortening operating times and reducing blood loss. They accomplish this feat by allowing precision cutting while simultaneously allowing the tissue to be coagulated. This reduces the number of instruments needed as well as the number of steps to obtain hemostasis. Less bleeding means better visualization of the surgical field, which can further shorten surgical time.

Reduced blood loss also improves patient safety. Lower blood loss reduces the need for blood transfusions. Electrosurgical units also allow for more precise control of the surgical margins. Cutting and coagulating at the same time can reduce the risk of bacterial contamination and infection.

Better precision, lower infection risk, and less blood loss lead to smaller cuts. This results in less pain after surgery and quicker recovery for patients. This improves clinical outcomes.

Electrosurgical units are a staple piece of equipment in hospital operating rooms. Small clinics face several challenges, especially compared to larger hospitals. Some of these include:

• Budget: Every facility has budget limits, but small clinics may have even tighter budgets for several reasons.
• Maintenance and training: Larger facilities may have staff on-site to maintain their equipment and train new staff, while smaller clinics may not have this option. Even if big facilities lack maintenance and training staff, they can still save money. It is often cheaper to service many pieces of equipment than just a few in a small clinic.
• Obsolescence: Technology is rapidly advancing, and electrosurgical units are no exception. These advancements may lead to the need for more frequent upgrades and replacements as the standard of care adapts. This can be difficult for smaller facilities.
• Purchasing power: Smaller clinics usually buy in lower amounts. This means they have fewer supplier options and less bargaining power than larger hospitals. This can make it difficult to get competitive pricing.

Critical Features to Look for in 2025

As technology advances, you should look for several features when purchasing an electrosurgical unit in 2025.

Power Range

The types of surgical procedures your facility performs will affect what type of unit you may choose to purchase. Electrosurgical units have a range of power settings that are used for different applications. Many office-based procedures have lower power needs than procedures performed in operating rooms or surgery centers.

It is important to adjust the power settings of your unit. This helps meet the needs of each surgeon and the specific procedure.

Safety Systems

The safety of your patients and staff is likely a top concern when considering electrosurgical units. Electrosurgical units usually have many safety systems. These features are important to consider when buying a unit in 2025.

• Electrode monitoring: Active electrode monitoring systems will monitor the active electrode during surgery and deactivate the unit if the unit is compromised. This can help prevent burns to the patient.
• Return electrode monitoring systems: These systems check the return electrode. They ensure good contact to protect the patient from burns at the return electrode sites. They will trigger an alarm and deactivate the unit as necessary.
• Alarms can be visual or audible. These will alert your staff to any concerns or potentially harmful conditions with the machine. The type and volume of the alarm may be a factor for you to consider for your practice.

No matter which safety features you choose, proper training for your staff is essential. This ensures everyone knows how to use the machine correctly.

Usability

An ideal electrosurgical unit should be intuitive and easy to use. Some usability features to think about are if the unit has a foot pedal or a button on the tip to control the currents.

For some clinics, a touch screen may be more desirable than dials. The easier a unit is to use, the easier it is to train. If the staff has to fiddle with the machine, it can decrease workflow efficiency.

Portability and Size

The size and portability of the unit play a key role in your choice of unit for your practice. If the unit needs to be moved in multiple locations, a smaller, more portable unit may be necessary. Some units can add features like argon lasers. These can reduce the space needed for equipment in your procedure suite or operating room.

The procedures your practice will perform can affect the number of tools and accessories you need. This can also impact the portability and size of your equipment.

Cost of Ownership

Cost of ownership is not limited to the purchase price. Other things to consider include:

• Maintenance costs
• Repair costs
• Cost of accessories (such as cautery tips, smoke evacuators, electrodes, generators, filters, etc.)
• Cost of training staff
• Energy consumption
• Disposal costs

Some ownership costs can be reduced with warranty replacements. However, all these costs should be considered when choosing the right electrosurgical unit for your practice.

Best Electrosurgical Units for Small Clinics (2025 Edition)

Model	Power Output	Best For	Pros	Cons	Price Range
Valleylab FT10 from Covidien	Max 300 W	Wide range of specialties	-Speed -Efficiency -Advanced technology -Monopolar and bipolar applications	-Software recall in November 2023 -Potential security vulnerability	9,000-18,000
MEGADYNE Electrosurgical Generator by Ethicon	Monopolar 120-300W Bipolar 80W GEM 150W	Gen surg Controlled coagulation Minimally invasive approaches	-optimized energy delivery -multiple modes -user friendly -Monopolar and bipolar	-2024 recall for some of the return electrodes -risk of burn with prolonged use -limited compatibility across models	6,000-18,000
VIO 3 Electrosurgical Unit from Erbe	Max 400W cut Max 360 W coag	Endoscopic dissection Minimally invasive procedures Ablation Resection in saline	-optimized modes -adaptive tissue technology -instrument compatibility -precision Intuitive interface	-may have a longer learning curve -higher cost -overreliance on automated technology	6,000->10,000
System 5000 Electrosurgical Unit by Conmed	Max 300 W for monopolar with blend settings Max 90 W for bipolar	Gen surg Laparoscopic surgery Procedures in fluid Precise dissection	-precision -safety features -versatility -programmable memory	-complexity -cost	5,000-22,000
Gen 11 Harmonic Scalpel Electrosurgical Unit by Ethicon	Max continuous output 35W for harmonic	Minimally invasive procedures Gen surg ENT Plastic surgery Thoracic surgery Peds surgery	-shorter operating times -less blood loss -minimal thermal damage -adaptive tissue technology	-high initial cost -tissue sticking potential -learning curve -more limited procedure options	7,000-16,000

Common Mistakes to Avoid

When choosing an electrosurgical unit, there are several pitfalls to avoid.

Buying More Power Than Needed

Buying a unit with more power than you need can lead to higher initial costs. It can also increase ongoing costs, like power consumption. It may also increase the risk of complications such as unintended burns or damage to surrounding tissues.

Choosing Non-FDA-Cleared or Legacy Units

Non-FDA-cleared electrosurgery units may not undergo the same rigorous safety and efficacy testing. These units are often approved for aesthetic purposes and not necessarily for surgical procedures. This may increase the risk of complications.

Legacy units have outlived their manufacturer support and may not receive security and software updates. This may leave them vulnerable to cybersecurity threats and may potentially open your practice to additional liability.

Ignoring the Warranty or Service Support

Maintaining your equipment is vital to its longevity. Improper maintenance may affect warranty support in some cases. Lack of maintenance may also lead to more downtime, which affects your surgery schedule and productivity.

Failing to Train Staff Properly

Proper training of staff members is important to the safe operation of any equipment. Improper training can result in injuries to patients, damage to equipment, and even fires. Proper training, ongoing competency evaluations, and regular review of safety protocols can help minimize these risks.

Buying Tips and Recommendations: Electrosurgical Units

When choosing an electrosurgical unit for your medical practice, keep these tips in mind.

Consider a Certified Refurbished Unit

A refurbished unit can save you a significant amount in initial investment. You may be able to purchase a higher-end machine for a lower cost by considering this option. Units that are certified refurbished must adhere to strict guidelines to meet the original manufacturer’s expectations. These units undergo extensive testing to ensure their functionality and generally come with a warranty.

Ask for a Demo Before Committing

Gaining hands-on experience with an electrosurgical unit helps you see how it works. You can also find out if the controls are easy for your staff to use. You may choose to demo several units to find the one that best meets your needs.

Check Return Policies and Tech Support Availability

If you buy a unit and find it does not meet your needs, will the distributor help you return it? Can they help you find a better option? Is tech support available during the times when you are performing procedures and may need it to troubleshoot? These are things to consider when you are purchasing a unit. The after-purchase support is as important, if not more important, than the initial purchase support.

Match Unit Specs with Clinic Procedures

The best unit for your practice is one that will match the needs of the procedures that your practice performs. An electrosurgical unit that is well matched to your procedural needs will improve your workflow efficiency and keep your patients safe.

FAQs

What is the difference between monopolar and bipolar electrosurgical units?

Monopolar electrosurgical units pass the electrical current from the active electrode through the patient’s body to the receiving electrode.

Bipolar units have both the active and passive electrodes in the same unit. The electrical current passes between the two electrodes and any intervening tissue. These are often in the form of forceps.

Are refurbished units safe?

Certified refurbished units undergo rigorous testing and should meet or exceed the original manufacturer’s specifications, making them a safe and reasonable option.

How often should electrosurgical units be serviced?

Each manufacturer will have specific recommendations for how often testing and maintenance should be performed. Many manufacturers recommend twice-yearly maintenance, while others may recommend annual testing. Check with the manufacturer as to what is recommended for the units you are considering.

Final Thoughts

When searching for the best electrosurgical units in 2025, consider the cost, safety, and functionality. Balance these factors to meet your specific practice needs.

Many reliable brands and units are available when considering the top ESUs for clinics. We have reviewed several of the well-known brands with good reliability reputations. To learn more about options for your practice, or to see unit demos, visit us today. We offer affordable electrosurgical machines.

References

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8. Diamond Surgical. (2024, October 18). Electrosurgical unit in surgery: Key applications & benefits. Retrieved from https://diamondsurgical.com/electrosurgical-unit-in-surgery-applications-benefits-and-safety-considerations/
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