Transcript Tissue Response Generator

TM
Computer controlled INSTANT RESPONSE™ system provides
safer and more precise electrosurgery.
Tissue Response Technology
Tissue Impedance
Computer Controlled
INPUT
OUTPUT
Computer Controlled Tissue Response
Technology

Responds instantly to
changes in tissue
impedance/resistance.

Maintains clinical effect
over a wide range of
tissue
impedances/resistances.
Tissue Response Generator
The computer circuit is:

Automatically invoked
• All cut modes
• All bipolar modes

Not applied to coag modes
• Fulguration capabilities
Tissue Response Generator
The computer circuit senses tissue
impedance/resistance

Tissue types vary in impedance/resistance

Effective over a wide range of tissue
impedances/resistances
Approximate Tissue Impedance/Resistance Ranges
Lung, Scar, Adhesions
Mesentary, Brain White Matter,
Omentum
Bowel, Brain Gray Matter, Adipose, Spleen
Gall Bladder
Oral Cavity, Liver
Prostate in nonconductive solution
Muscle, Eye, Skin, Kidney, Pancreas
Buzz Hemostats
Desiccate - stop bleeding
0
1000
2000
3000
4000
Increasing tissue impedance/resistance
Resistance in Ohms at Radio Frequency
when Cutting or Desiccating
KEY
resistance
when bloody
resistance
when dry
5000
Tissue Response Generator
Computer controlled output is automatically
adjusted

Provides instant response to changes in
tissue impedance/resistance

Produces consistent tissue effect

Controls maximum output voltage
• Reduces capacitive coupling and video
interference
• Minimizes sparking
Thermal Damage
Standard ES
Average thermal spread = .35 mm
Tissue Response
Average thermal spread = .14 mm
50% reduction in thermal spread

Tissue response produces equivalent tissue effect
at lower power settings
Capacitively Coupled Current Measured
on a Metal Cannula
260
Tissue Response
Standard ES
240
Current (mAmps)
220
Coag at 120 Watts
200
180
160
140
120
100
80
200
300
1000
Impedance (ohms)
2000
Tissue Response Generator
Peak to Peak Voltage
Generator Technology Comparison in Pure Cut
6000
5000
4000
Volts
3000
2000
1000
0
Ground
Balanced
Referenced Output
Isolated
Tissue
Tissue
Response Response
(Low Pure)
Tissue Response Generator
Output Power vs Resistance
Tissue Response Pure Cut Mode vs Conventional Pure Cut Modes
Cut A
400
Cut B
350
Tissue Response
Output Power in Watts
300
250
Generator
Setting
300W
200
150
100
50
0
0
200
400
600
800
1000
1200
1400
Increasing tissue impedance/resistance
Resistance in Ohms
1600
1800
2000
Tissue Response Generator
Output Power vs Resistance
Tissue Response Blended Cut Mode vs Conventional Blended Cut Mode
Conventional Blend
250
Tissue Response
Output Power in Watts
200
150
Generator
Setting
200W
100
50
0
0
200
400
600
800
1000
1200
1400
Increasing tissue impedance/resistance
Resistance in Ohms
1600
1800
2000
Tissue Response Generator
Advantages in Monopolar
Provides computer controlled output in:

Cut Mode
• Less thermal damage to adjacent tissue
• Lower power settings required to achieve
desired effect
• Less sparking  reduced stimulation of nerves
and muscles
• Reduced drag

Spray Coag Mode
• Wide area of effect with less spot penetration
Tissue Response Generator
Advantages in Bipolar
Provides computer controlled output in:

Low
• Delicate tissue
• Fine control of desiccation
• Low voltage  prevents sparking

Med
• Standard tissue application
• Low voltage  prevents sparking

Macro
• Higher resistance tissue
• Higher voltage available
• Designed to function with new generation of laparoscopic
instruments
Standard ES
Tissue Response
Bipolar Coagulation
High voltage causes
sticking and charring
Voltage is limited to reduce
sticking and charring
Reduces power to slow
coagulation
Maintains power to speed
coagulation
Macrobipolar
Reduces power into high
impedances to limit cut
capability
Maintains power in high
impedance tissue to reduce
drag
Tissue Response Generator
Incorporates previous technology safety features

Isolation

Return electrode monitoring
Functions with other technologies

Argon enhanced electrosurgery
Accepts current accessories

Monopolar electrodes and footswitches

Bipolar electrodes and footswitches
Tissue Response Generator
Surgical Applications
General

Laparotomy incision

Mastectomy
Urology

TUR Prostate
GYN
Orthopedics
Plastic
Skin
Fat
Muscle
Fascia
Peritoneum