How is energy dispersed in electrosurgery? I'm a surgeon and I use electrosurgical units on a near daily basis. From time to time I have questions about the nuances of these tools. Today, this one came to mind...
Assume:

*

*The bladder is filled with an ionic solution.

*The bladder is a sphere.

*A monopolar electrode is suspended in the center of the bladder/sphere.

*The dispersion/return electrode is on the patient's left thigh

If the device is activated will the energy dissipate to all surfaces of the bladder OR will it concentrate on the left side of the bladder given the location of the dispersion electrode?
 A: The ionic contents of the bladder are a good conductor of electricity, so the initial tendency of the current flow will be to uniformly distribute itself radially throughout the solution and reach the bladder walls isotropically i.e., not hot spots or dead spots.
Now the fleshy tissue and lymph-like (saline) fluid that surrounds the outside of the bladder as it sits inside the abdominal cavity are fairly good conductors too, so the tendency of the current flow will be similarly uniform, out through the walls of the bladder and into the surroundings.
The cross-sectional area of conductive tissue between the bladder surroundings relative to the linear distance to the thigh electrode is such that there will be no current "crowding" until the current is fairly close to the thigh electrode. This means that the current leaving the outside of the bladder wall will be uniform and even though the return electrode is asymmetrically disposed relative to the bladder, the effect of the current flow will be uniform all around the inside of the bladder walls.
