Electrosurgical Procedures - Cooper Surgical LEEP PRECISION LP-10-120 Bedienungsanleitung

5.6 Electrosurgical Procedures

This section provides only general information about the use of electrosurgical devices . Only the user can
evaluate the clinical factors involved with each patient and determine if the use of this equipment is indicated .
The user must then decide on the specific technique and procedure that will accomplish the desired
clinical effect .
LEEP PRECISION Generators are designed to allow the controlled destruction
of tissue and are inherently dangerous if operated improperly .
REPORTED PROBLEMS DUE TO IMPROPER OPERATION DURING
ELECTROSURGICAL PROCEDURES HAVE INCLUDED:
•
Inadvertent activation with resultant tissue damage at the wrong site and/or
equipment damage
•
Alternate current pathways resulting in burns where the patient, physician, or
assistant is in contact with exposed metal
•
Explosions caused by electrosurgical sparking in a flammable gas mixture
(i .e ., explosive anesthetic gases and the inappropriate use of alcohol and
other flammable liquids)
•
Perforation and massive hemorrhage
A proper Patient Return Electrode pathway is extremely important during any
monopolar electrosurgical procedure . Every effort must be made to ensure that,
throughout the electrosurgical procedure, an adequate surface area is provided
and remains in proper contact with the patient to reduce the current density
below a level that might cause inadvertent tissue damage where the Patient
Return Electrode has been applied .
5.6.1 Electrosurgical Tissue Effect
Delivery of continuous sinusoid waveform currents through a small electrode at appropriate power
levels can cause rapid heating of the intracellular fluids in the cells in close proximity to the
electrode, turning these fluids to steam. The significant increase in volume (approximately five times) causes
cellular structures to rupture, creating the clinical effect of CUT, with little or no
hemostatic effect along the margin of the divided tissue . Delivery of short-duration pulses of
RF currents through a small electrode at appropriate power levels can cause heating of intracellular fluids at a
more gradual pace. This allows evaporation of these fluids without rupturing the cellular structure, creating the
clinical effect of desiccation, or COAG, without the division of tissue .
By varying the pulse to an intermediate duration, it is possible to get a clinical effect that combines or blends
the clinical characteristics of CUT and COAG, yielding the effect referred to as BLEND,
in which tissue is divided with a desirable amount of hemostatis along the margins of the
divided tissue .
The LEEP PRECISION Generator has output load characteristics that cause the electrosurgical
effects to remain consistent throughout the procedure . However, under some circumstances, it may be
necessary to readjust the power settings during the procedure .
The electrosurgical effect may vary throughout the procedure, requiring the operator to adjust the
LEEP PRECISION Generator relative power settings .
WARNING
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