Electrosurgery Explained: From Galvanic Cells to the Goble Brothers — A Brief History of Electrosurgery

Early Electrical Heating and Galvanic Cells (Mid-1800s)

Three years after this, Albrecht Theodor Middeldorpf published a paper on the use of a zinc–iron battery-powered platinum electrosurgical snare to perform galvanocautery of a polypoid throat tumour, which had been carried out the year before at the Allerheiligen-Hospital in Breslau.² 

These early uses were distinctly different from what we now define as electrosurgery, in that direct current (DC) was used to heat cutting elements to high temperatures. Nevertheless, this represented an important stepping stone toward later developments.

High-Frequency Current and Reduced Neuromuscular Stimulation

Later in the 19th century, experiments conducted by d’Arsonval and Nikola Tesla demonstrated that high-frequency electrical currents could minimise muscle contraction during surgery. This was a critical development, as it significantly improved the safety profile of electrically assisted surgical procedures and would ultimately enable broader clinical adoption. 

These findings formed the basis for the use of high-frequency electrical current to treat tissue, which we now refer to as electrosurgery.

Diathermy and the Classification of Tissue Effects (Early 1900s)

At the start of the 20th century, Karl Franz Nagelschmidt, a pioneer in the application of high-frequency currents for surgical use, coined the term “diathermy,” derived from the Greek words διά (dia) and θέρμη (thermē), meaning “heating through.” 

Shortly thereafter, in 1911, U.S. surgeon William Clark demonstrated desiccation of surface lesions. By this stage, various differentiated forms of high-frequency tissue effect had been described, including cutting, coagulation, desiccation, and fulguration (surface charring). These classifications remain fundamental to the design of electrosurgical systems today.

The Bovie Generator and Controlled RF Waveforms

In the 1920s, biophysicist and inventor William T. Bovie developed his now-famous electrosurgical generator, which, in the hands of neurosurgeon Harvey Cushing, was initially used to remove a cranial mass. 

The system featured adjustable current and waveform controls—operated by Bovie himself during its first use³—and was powered by an AC supply tapped from a nearby streetlight. While rudimentary by modern standards, this system introduced the concept of waveform control to achieve repeatable tissue effects, marking a turning point in the engineering of electrosurgical devices.

From Spark Gaps to Solid-State Electronics (Mid–Late 20th Century)

Over the next 50 years, the adoption of electrosurgical systems became increasingly widespread. Early spark-gap generators were replaced by vacuum-tube technology, allowing more consistent and controllable tissue effects. 

These systems were later superseded by solid-state electronics, enabling generators to become more compact, precise, and reliable. Solid-state architectures also improved repeatability and control, supporting the expansion of electrosurgery across a growing range of clinical applications.

The Goble Brothers and Saline-Based PlasmaKinetic™ Technology

Five decades after the first clinical use of the Bovie system, brothers Colin and Mark Goble—an analogue electronics engineer and a minimally invasive surgeon, respectively—founded Gyrus Medical Ltd in 1989. Their aim was to develop advanced electrosurgical systems, initially targeting urology and gynaecology applications. 

The launch of the PlasmaKinetic™ system in 1998 enabled surgeons to access highly controlled tissue-cutting technology while minimising thermal necrosis. Prior to this innovation, procedures such as Transurethral Resection of the Prostate (TURP) commonly relied on non-conductive irrigation media such as glycine. These fluids could result in serious complications, including TUR syndrome, where dangerously low sodium levels (hyponatraemia) occur in the patient. 

By enabling the use of isotonic saline as the irrigation medium—acting as the conductive electrolyte—the PlasmaKinetic™ approach eliminated this risk. This advancement significantly improved procedural safety and helped establish saline-based electrosurgery as a mainstream technique.

ATL Technology and the Continued Evolution of RF Electrosurgery

To this day, ATL Technology continues to innovate and advance RF (Radio Frequency) electrosurgical technology at the same Cardiff site where the Goble brothers first launched their pioneering systems. ATL’s electrosurgical engineering team can support OEMs developing RF electrosurgical instruments and capital equipment across a wide range of clinical applications, device architectures, and desired tissue effects. 

The team builds on decades of RF engineering expertise and system-level understanding to help partners shape the future of electrosurgery.

In the next blog in this series, basic electrode configurations and their relative merits will be discussed.