Transcript CESO_SEMINARS_2002_AMT_Presentation_June_10_02

AMT ELECTROSURGERY
INTEGRATING SAFETY AND PERFORMANCE
BASICS OF ELECTROSURGERY
Basics of Electricity
Electrosurgial Principles
• Current follows pathway of least
resistance
• Current always seeks to complete the
circuit
• As Resistance within the circuit
increases, current flow decreases
Neromuscular Stimulation
Tissue Effects:
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Cutting
Desiccation
Fulguration
Soft Coagulation
Bipolar
Argon Plasma Coagulation
Cutting
• Continuous high-frequency current
– Cause quick, clean cutting
– Minimal Thermal Artifact
• Blended Current
− Combination of cutting and coagulation
waveform characteristics
− Moderate hemostasis
Desiccation (Forced Coag)
• Contact Coagulation
– Slow drying out of tissue
– Varying degrees of thermal artifact
– Causes eschar to form
Fulguration (Spray Coag)
• Non contact
• High Voltage
• Electrical current arcs from electrode to
tissue
• Superficial
Soft Coagulation
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Contact Coagulation
Low Voltage
Continuous waveform
Non Sticking non charring
Reproducible
Bipolar
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Contact coagulation
Low voltage
Safer than monopolar
Non charring
Argon Plasma Coagulation
• Non contact
• Non Charring
• Superficial
Argon Plasma Coagulation
Argon Plasma Coagulation
ESU’s
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Conventional
Constant Voltage
Hyfrecator
Argon Plasma Coagulation
Return Electrodes
• Non CQMS
• CQMS
• Capacitive Pads
CQMS Technology
Capacitive Pad
Active Electrodes:
• Monopolar
– Pencils
– Laparoscopic
– Forceps
• Bipolar
– Laparoscopic
– Forceps
Troubleshooting
• Operator Errors
• System Errors
• Accessory Failures
Buzzing a Hemostat
• Good Practice?
• How to do it safely
Surgical Staff Burns
• How do they occur?
• How to avoid them