Monopolar and Bipolar

In practice

Compare them in order. First, in monopolar electrosurgery, the active electrode is at the surgical site, and current travels through the patient to a return electrode, the dispersive pad, placed elsewhere on the body. Second, in bipolar electrosurgery, the two tips of a forceps act as the active and return electrodes, so only the tissue between the tips is in the circuit and no dispersive pad is needed. Third, bipolar works even in a wet field. Fourth, monopolar coagulation spreads more heat into nearby tissue than bipolar does. Fifth, monopolar devices carry specific risks, such as pad burns, insulation failure and current coupling.