Comparative Healing of Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Scalpel

Loh, Shang A.; Carlson, Grace; Chang, Edward I.; Huang, Eric J.; Palanker, Daniel; Gurtner, Geoffrey C.

doi:10.1097/prs.0b013e3181bcee87

Cited by 109 publications

(126 citation statements)

References 27 publications

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“…Although the source of this false signal is not yet fully understood, current evidence from preclinical experiments points toward long-lived, thermally induced chemiluminescence (25). Because the emission seems to be related to temperature, which can reach up to 250°C at the tip of the diathermy device, electrosurgical devices that operate at much lower temperatures are currently being tested (26). In addition to potentially facilitating margin assessment on intact WLE specimens, an advantage of low-temperature devices over monopolar diathermy is the reduced collateral tissue damage, which could also improve the accuracy of assessing tumor resection margins on histopathology (27).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Assessment of Tumor Resection Margins in Breast-Conserving Surgery Using ¹⁸F-FDG Cerenkov Luminescence Imaging: A First-in-Human Feasibility Study

et al. 2016

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In early-stage breast cancer, the primary treatment option for most women is breast-conserving surgery (BCS). There is a clear need for more accurate techniques to assess resection margins intraoperatively, because on average 20% of patients require further surgery to achieve clear margins. Cerenkov luminescence imaging (CLI) combines optical and molecular imaging by detecting light emitted by 18 F-FDG. Its high-resolution and small size imaging equipment make CLI a promising technology for intraoperative margin assessment. A first-in-human study was conducted to evaluate the feasibility of 18 F-FDG CLI for intraoperative assessment of tumor margins in BCS. Methods: Twenty-two patients with invasive breast cancer received 18 F-FDG (5 MBq/kg) 45-60 min before surgery. Sentinel lymph node biopsy was performed using an increased 99m Tc-nanocolloid activity of 150 MBq to facilitate nodal detection against the g-probe background signal (cross-talk) from 18 F-FDG. The cross-talk and 99m Tc dose required was evaluated in 2 lead-in studies. Immediately after excision, specimens were imaged intraoperatively in an investigational CLI system. The first 10 patients were used to optimize the imaging protocol; the remaining 12 patients were included in the analysis dataset. Cerenkov luminescence images from incised BCS specimens were analyzed postoperatively by 2 surgeons blinded to the histopathology results, and mean radiance and margin distance were measured. The agreement between margin distance on CLI and histopathology was assessed. Radiation doses to staff were measured. Results: Ten of the 12 patients had an elevated tumor radiance on CLI. Mean radiance and tumor-to-background ratio were 560 6 160 photons/s/cm 2 /sr and 2.41 6 0.54, respectively. All 15 assessable margins were clear on CLI and histopathology. The agreement in margin distance and interrater agreement was good (k 5 0.81 and 0.912, respectively). Sentinel lymph nodes were successfully detected in all patients. The radiation dose to staff was low; surgeons received a mean dose of 34 6 15 mSv per procedure. Conclusion: Intraoperative 18 F-FDG CLI is a promising, low-risk technique for intraoperative assessment of tumor margins in BCS. A randomized controlled trial will evaluate the impact of this technique on reexcision rates. In early-stage breast cancer, the primary treatment option for most women is breast-conserving surgery (BCS) by wide local excision (WLE) of the tumor. WLE often fails to achieve clear surgical margins, and on average 20% of patients who undergo BCS will require repeated surgery to achieve clear margins (1) (although this may vary because there is no global agreement of the definition of clear margins). Reoperations potentially have several negative consequences including delayed commencement of adjuvant therapy, worse cosmesis, increased patient anxiety, and costs (2,3).There have been several attempts to assess surgical margins intraoperatively to reduce breast cancer reoperation rates after WLE (1). Techniques evaluated to date in...

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Section: Discussionmentioning

confidence: 99%

Intraoperative Assessment of Tumor Resection Margins in Breast-Conserving Surgery Using ¹⁸F-FDG Cerenkov Luminescence Imaging: A First-in-Human Feasibility Study

et al. 2016

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“…PEAK PlasmaBlade has an average operating temperature of 40-170°C when used during surgery. The zone of thermal injury in PEAK PlasmaBlade incision (0.6 cm) was significantly smaller when compared to electrosurgical cut or coagulation incisions (4 cm) 6 . Thus, PEAK PlasmaBlade can be used nearby critical structures with lesser risk of vascular injury.…”

Section: Discussionmentioning

confidence: 98%

“…In another study, coblation tonsillectomy had shown a drastic decrease in postoperative pain comparing with conventional technique 8,9 . As for PEAK PlasmaBlade versus conventional surgery, one study showed significant reduction in thermal injury and improved wound strength and histology with better visual assesment of scars 6 . It has been shown that PEAK PlasmaBlade reduces level of inflammation, thus leading to good epithelization resulting in improved healing and cosmesis [10][11][12] .…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it operates at lower temperatures which result in less postoperative pain. Peak PlasmaBlade approach has made a significant difference in that it decreased thermal injury profile which avoids inflammatory response and helps in rapid wound healing 6 . PEAK PlasmaBlade has an average operating temperature of 40-170°C when used during surgery.…”

Section: Discussionmentioning

confidence: 99%

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Peak Plasma Blade and Coblation Adenotonsillectomy: Report Of 2 Cases and Literature Review

Nagarajah¹,

Appannan²,

Lazim³

et al. 2018

MMJ

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“…The mechanism of plasmakinetic depends on a plasma formation that creates an electrically conductive cloud, when radiofrequency energy contacts tissue. 9 An advantage of plasmakineti is cutting the tissues at much lower average temparature (as low as 50°C) than conventional electrocautery. 10 In the PKVP procedure, the current between the active and return electrode forms a plasma ball, which vaporizes the tissue on contact with a very high temperature and low thermal mass.…”

Section: Discussionmentioning

confidence: 99%

Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

Karadağ

Çeçen

Demir

et al. 2014

CUAJ

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Introduction: We evaluate the efficacy and outcomes of plasmakinetic vaporization (PKVP) and plasmakinetic resection (PKR) to treat benign prostatic hyperplasia (BPH).Methods: A total of 183 patients with BPH underwent plasmakinetic prostatic surgery between 2008 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine, Turkey. After clinical and preoperative evaluation, the patients were randomized to PKRP or PKVP groups sequentially by using computer-generated numbers. Group 1 included 96 patients treated with PKR. Group 2 included 87 patients treated with PKVP. Patients in both groups were compared in terms of hemoglobin drop, operation time, catheter duration, reobstruction, incontinence and recatheterization.Results: When we compared the maximum flow rates (Qmax values) at the 12th month, there was no statistical difference between 2 groups. Group 1 had a mean Qmax value of 17.92 ± 3.819 and Group 2 had a 18.15 ± 3.832 value (p > 0.05). There was a statistical difference between the groups in terms of hemoglobin drop, catheter duration and operation time. The mean catheter duration in Group 1 was 3.74 ± 1.049 days, and in Group 2 it was 2.64 ± 0.849 days (p < 0.05). Operation time was statistically longer in Group 2 (PKVP) and hemoglobin drop was statistically higher in Group 1 (PKR).Conclusion: PKVP for BPH is safe and effective. When compared with PKRP, it provides a significantly shorter catheter duration and less bleeding due to hemostasis control with similar IPSS and Qmax improvements after 1 year.

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Comparative Healing of Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Scalpel

Abstract: The PlasmaBlade is a promising new surgical instrument that provides atraumatic, scalpel-like cutting precision and electrosurgical-like hemostasis, resulting in minimal bleeding, tissue injury, and scar formation.

Cited by 109 publications

References 27 publications

Intraoperative Assessment of Tumor Resection Margins in Breast-Conserving Surgery Using ¹⁸F-FDG Cerenkov Luminescence Imaging: A First-in-Human Feasibility Study

Intraoperative Assessment of Tumor Resection Margins in Breast-Conserving Surgery Using ¹⁸F-FDG Cerenkov Luminescence Imaging: A First-in-Human Feasibility Study

Peak Plasma Blade and Coblation Adenotonsillectomy: Report Of 2 Cases and Literature Review

Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

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Comparative Healing of Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Scalpel

Abstract: The PlasmaBlade is a promising new surgical instrument that provides atraumatic, scalpel-like cutting precision and electrosurgical-like hemostasis, resulting in minimal bleeding, tissue injury, and scar formation.

Cited by 109 publications

References 27 publications

Intraoperative Assessment of Tumor Resection Margins in Breast-Conserving Surgery Using 18F-FDG Cerenkov Luminescence Imaging: A First-in-Human Feasibility Study

Intraoperative Assessment of Tumor Resection Margins in Breast-Conserving Surgery Using 18F-FDG Cerenkov Luminescence Imaging: A First-in-Human Feasibility Study

Peak Plasma Blade and Coblation Adenotonsillectomy: Report Of 2 Cases and Literature Review

Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

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Product

Resources

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Intraoperative Assessment of Tumor Resection Margins in Breast-Conserving Surgery Using ¹⁸F-FDG Cerenkov Luminescence Imaging: A First-in-Human Feasibility Study

Intraoperative Assessment of Tumor Resection Margins in Breast-Conserving Surgery Using ¹⁸F-FDG Cerenkov Luminescence Imaging: A First-in-Human Feasibility Study