What is a Bovie Cautery?

Bovie cautery is a surgical procedure performed with the use of a “bovie,” a medical device that cuts and seals, or cauterizes, tissues and blood vessels by way of a direct electrical current. A scapel is not used. Touching body tissues with heated prongs on the end of the bovie transfers heat to the tissues, destroying those in immediate contact and cauterizing adjacent tissues. For this reason, bovie cautery is also called “thermocautery” or “electrocautery.”

Bovie cautery works by directly applying an electrically heated prong to tissue that needs to be cauterized, so it is most accurately characterized as electrocautery, rather than electrosurgery. A modern electrosurgical unit (ESU) can have added instruments and settings that allow electrocautery functions, such as a surgical blade, or “bovie knife,” that allows surgeons to rapidly cauterize and clear operative fields when performing major surgeries of the spine, thorax, and abdomen.

Portable bovie cautery units are widely used today in emergency rooms and in outpatient settings such as clinics and doctor’s offices where medical procedures can also be performed. These bovie units are increasingly used for outpatient surgery in many medical specialties, including plastic surgery, dermatology, gynecology, urology, dentistry, and otolaryngology. A suction bovie is widely used to perform adenoidectomies, because it has a hollow central stem that is used to suck blood from the throat area during surgery, allowing better vision of the area and also helping to improve patient comfort.

Portable bovies are battery-powered and shaped like a pen; some newer shapes resemble a pencil and use microtips. These portable units can achieve a temperature of 2,200°F (1,204°C) without requiring high-frequency currents or generators. Their length generally varies from around 3.5 inches (8.9 cm) to 8 inches (20.3 cm), and they can have disposable or replaceable wire loop tips varying from 3/16-inch (5 mm) to microtip sizes of 2/5-inch (0.1 cm) to about 1/16-inch (0.2 cm).

Bovie cautery is used to cut and coagulate animal and human tissue. It is widely used as a cauterizing agent in veterinary surgery. This form of cautery, along with lasers, is now largely used instead of treatment by freezing, or cryotherapy, to treat tumors and warts in humans. Traditional chemocautery, using cauterizing agents such as silver nitrate, tends to be favored by veterinarians for animal treatment.

Extensive safety procedures are taken in operating rooms when using the bovie apparatus, because severe burns can result during the use of high-frequency alternating current without adequate protection. Fire, shock, and smoke inhalation are other hazards. Outpatient cautery, however, presents few of these hazards because it uses self-contained, battery-operated units and less extensive surgical areas. It has also been noted in clinical literature that the use of bovie cautery has reduced operative time, bleeding, and infection, as well as reducing patient pain.