Electrosurgical generators

Slivka, Adam; Bosco, John J.; Barkun, Alan N.; Isenberg, Gerard; Nguyen, C.; Petersen, Bret T.; Silverman, William B.; Taitelbaum, Greta; Ginsberg, Gregory G.

doi:10.1016/s0016-5107(03)02012-1

Cited by 27 publications

(10 citation statements)

References 14 publications

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“…The main indication for application of electrosurgical energy is snare colonoscopic polypectomy with blended or pure coagulation current [10] . Argon plasma has been successfully used for hemostasis of vascular ectasias, for ablation of intestinal polyps or residual adenomatous tissue after colonic polypectomy, and for the endoscopic therapy of postradiation colitis [11] .…”

Section: Indications For Colonoscopy With Electrocauterymentioning

confidence: 99%

“…Electrosurgical generators may supply two types of circuits, monopolar and bipolar. Electrosurgical cutting is achieved by a high voltage (> 200 V) continuous current [10] .…”

Section: Electrosurgical Generatorsmentioning

confidence: 99%

“…Argon plasma coagulation is a noncontact electrocoagulation device that uses high-frequency monopolar current conducted to target tissues through ionized argon gas [10] . Argon plasma delivered through a flexible probe passed through the accessory channel and allows treatment of a large area quickly [13] .…”

Section: Argon Plasma Coagulationmentioning

confidence: 99%

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Colonic gas explosion during therapeutic colonoscopy with electrocautery

Ladas

Karamanolis²,

Ben-Soussan³

2007

WJG

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Therapeutic colonoscopy with electrocautery is widely used around the world. Adequate colonic cleansing is considered a crucial factor for the safety of this procedure. Colonic gas explosion, although rare, is one of the most frightening iatrogenic complications during colonoscopy with electrocautery. This complication is the result of an accumulation of colonic gases to explosive concentrations, but may be prevented by meticulous bowel preparation. The purpose of this review is to discuss the indications and the types of bowel preparations for therapeutic colonoscopy, and to contribute recommendations for the adequate bowel preparation for colonoscopy with electrocautery. © 2007 WJG . All rights reserved.Key words: Colonic gas explosion; Electrocautery; Therapeutic polypectomy; Argon plasma coagulation; Polypectomy Ladas SD, Karamanolis G, Ben-Soussan E. Colonic gas explosion during therapeutic colonoscopy with electrocautery. World J Gastroenterol 2007; 13(40): 5295-5298

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Section: Indications For Colonoscopy With Electrocauterymentioning

confidence: 99%

“…Electrosurgical generators may supply two types of circuits, monopolar and bipolar. Electrosurgical cutting is achieved by a high voltage (> 200 V) continuous current [10] .…”

Section: Electrosurgical Generatorsmentioning

confidence: 99%

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Colonic gas explosion during therapeutic colonoscopy with electrocautery

Ladas

Karamanolis²,

Ben-Soussan³

2007

WJG

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“…Thereafter, the cut is extended using blended cutting and coagulation current to reduce bleeding. Many ERCP endoscopists now use the ERBE™ generator (ERBE USA Marietta, GA) for this purpose; it employs feedback to regulate current density throughout the cut, greatly reducing the risk of an uncontrolled incision (the so-called "zipper" cut) (Slivka et al 2003). If pure current is used for the entire incision, bleeding is more likely, as susceptible blood vessels are not coagulated as they are cut.…”

Section: Sphincterotomymentioning

confidence: 99%

Diagnostic and Therapeutic Procedures in Gastroenterology

Wu¹,

Sridhar²

2011

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“…With the monopolar device, the current passes from the active electrode to the target lesions through the patient's body and finally exits the patient via a return electrode. With the bipolar device, the current only passes through the tissue between the two electrodes of the instrument [14,15]. More convenient and safer modes of treatment have been sought for resection of colorectal lesions larger than 10 mm and for bleeding because the digestive wall is thin, especially in the wall of the colon.…”

Section: Introductionmentioning

confidence: 99%

Safety of endoscopic procedures with monopolar versus bipolar instruments in an ex vivo porcine model

et al. 2020

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Background: Monopolar instruments are generally used in colorectal endoscopic mucosal resection (EMR). Bipolar instruments have previously been reported to be as safe as monopolar instruments. We sought to compare the safety of the monopolar and bipolar snare and hemostatic forceps in an animal model. Methods: We created 5-mm, 10-mm, and 15-mm target lesions on an ex vivo porcine rectum. Two lesions of each size were resected via monopolar polypectomy (M-P), monopolar EMR (M-E), bipolar polypectomy (B-P), and bipolar EMR (B-E). We performed a pathological evaluation of the conditions of perforation and the effects of burning on the tissues. In addition, we burned the muscularis propria covered with submucosal layer using monopolar and bipolar hemostatic forceps and performed pathological evaluations. Results: Polypectomy and EMR were performed in a total of 24 target lesions. A perforation was found on histology in one case of M-P and one case of M-E after removing target lesions of 15 mm in diameter. There were no perforations during endoscopic resection using the bipolar snare. The thermal denaturation in B-P did not reach the muscularis propria layer regardless of the size of the target lesion. Although thermal damage after using monopolar hemostatic forceps was extensive, thermal denaturation was only seen on the surface of the submucosal layer when bipolar hemostatic forceps were used. Conclusions: Bipolar instruments cause less damage to the tissue than monopolar instruments. Our results also suggest that bipolar instruments may be safer than monopolar instruments in endoscopic procedures for colorectal lesions.

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Electrosurgical generators

Cited by 27 publications

References 14 publications

Colonic gas explosion during therapeutic colonoscopy with electrocautery

Colonic gas explosion during therapeutic colonoscopy with electrocautery

Diagnostic and Therapeutic Procedures in Gastroenterology

Safety of endoscopic procedures with monopolar versus bipolar instruments in an ex vivo porcine model

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