Understanding the Bovie : Concept and Context
by CAMILLE WALTON , MS3 , BROOKE BARROW , MD , MORTON KASDAN , MD , & BRADON WILHELMI , MD
Introduction
The development of electrosurgery revolutionized the field of surgery , allowing for precise , simultaneous dissection and hemostasis of tissue . The “ Bovie ” is the modern descendant of generations of tools used for incising and cauterizing tissue . An understanding and appreciation of this device ’ s history , function and principles is described .
History of Hemostasis
The archeological record indicates that heated stones were used for cautery during the prehistoric era . 1 The earliest known written record of heat used to achieve hemostasis comes from an ancient Egyptian papyrus scroll dated to 3000 B . C . E . Ancient cultures from ancient China to sub-Saharan Africa to the Americas have used different heated materials to stop bleeding . 2 In texts dated around 300 B . C . E ., Hippocrates used a hot iron rod for the treatment of hemorrhoids . 3 In Europe during the Middle Ages , bleeding was controlled with the application of boiling oil or a heated iron . 4 In the early 1900s after the development of electricity , Joseph Rivière observed that an electrical current of the correct voltage had coagulating effects on tissue . 3 A quarter of a century later , the Bovie electrosurgery device was first used in 1926 . 5
History of Incising Tissue
The history of surgical cutting devices dates back as far as 600,000 18 LOUISVILLE MEDICINE
B . C . E . 6 The earliest ancestors to the modern-day scalpel included human teeth , leaf margins and sharp stone such as flint , jade and volcanic glass . 1 Eventually , humans began to manipulate stone and other materials into tools , and the knife was conceived during the Middle Stone Age ( ca . 8000 B . C . E .). 7 According to a text by Galen , Hippocrates was the first to develop a specialized surgical blade . 5 During this time ( ca . 300 B . C . E .), this tool would likely have been forged of copper or iron . 3 , 8
During the American Civil War , scalpels consisting of a handle and blade were constructed from a single piece of metal . They were replaced in 1905 when King Gillette introduced blades with double edges . These could be grasped with clamps and replaced when they dulled . The blade was prone to slipping within the clamp if not clasped firmly . 5 The modern two-piece scalpel , consisting of an interlocking handle and blade , was patented in 1915 by Morgan Parker and manufactured from stainless steel , which had been patented in 1913 . 5 This became known as the Bard-Parker scalpel .
History of the Bovie
William T . Bovie was born in 1882 and throughout his childhood displayed an interest in science via his insect collection and tinkering . 9 He attended the University of Michigan where he earned a bachelor ’ s degree , then proceeded to teach biology and geology at Antioch College . 10 In 1911 , Bovie began to pursue a doctorate in plant physiology at Harvard , where he conceptualized an intersection between biology and physics and was designated associate professor of biophysics from 1920 until 1927 . 10 It was during these years that he invented his electrosurgical device . The device was first used on a patient by Harvey W . Cushing , on Oct . 1 , 1926 , during the resection of a vascular myeloma . 1 Cushing published a paper shortly afterwards praising the device for its superior precision