Plasma Scalpels: Devices, Diagnostics, and Applications

Xiao, Ao; Liu, Dawei; He, Dongcheng; Lü, Xing; Ostrikov, Kostya

doi:10.3390/biomedicines10112967

Cited by 12 publications

(6 citation statements)

References 57 publications

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“…The importance of short coagulation was illustrated by the damaged volume [10] and depth being 1.1 and 1.3 mm after a 2 or 4 sec of bipolar coagulation with a setting of coag force three and 30W without mentioning the tip size. Plasma jets or plasma scalpels [11] are unlikely to permit pinpoint coagulation since a spark at a distance is not suited for intermittent or underwater coagulation or for localized coagulation.…”

Section: Discussionmentioning

confidence: 99%

Electrosurgery for the Gynaecologist: Cutting and Coagulating with One Instrument and One Setting

Koninckx,

Ussia,

Amro

et al. 2024

Preprint

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The relationship between tissue effects, intensity (I), and voltage (V) of a high-frequency alternative current seems well known. However, the translation of the settings of the electrosurgical unit and their use during surgery seems not to be unanimously understood by all surgeons. This results in many variations of surgical technique and plenty of specific questions asked during live surgery. Above 200 V, the heat of the sparks results in the explosion of superficial cells and a cutting effect. With higher voltages, the associated coagulation is increasing. Voltage and amount of energy (Watt=I*V) are independent since a similar amount of energy can be obtained with a continuous current or an intermittent current half the time and a double voltage. Below 200 V, tissue is heated until the steam from boiling tissue stops the current. Therefore, slower heating with less energy or a larger contact area permits deeper coagulation. The maximal output (W) of the electrosurgical unit results in versatility of use besides being a safety measure. The current intensity increases with the area of contact. Therefore, when I*V exceeds the preset output, V has to drop. A limited maximal output thus permits using the same instrument for non-contact cutting with >200V and sparks and coagulation when the contact area is much larger. In conclusion, the tissue effects of electrosurgery vary with the device’s voltage setting (often indicated as force) and the maximal output. The sur-geon’s choice to cut or coagulate by changing the contact area adds versatility.

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Section: Discussionmentioning

confidence: 99%

Electrosurgery for the Gynaecologist: Cutting and Coagulating with One Instrument and One Setting

Koninckx,

Ussia,

Amro

et al. 2024

Preprint

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“…APC is a relatively well tolerated, noncontact thermal hemostasis method used for tissue coagulation by discharging ionized argon gas (plasma) [56]. In the setting of acute LGIB, APC is recommended primarily for the treatment of superficial vascular lesions such as colorectal angioectasias [1 ▪▪ ].…”

Section: Patient Presentationmentioning

confidence: 99%

Diagnosis and management of acute lower gastrointestinal bleeding

Elimeleh,

Gralnek

2023

Current Opinion in Gastroenterology

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Purpose of review We review and summarize the most recent literature, including evidence-based guidelines, on the evaluation and management of acute lower gastrointestinal bleeding (LGIB). Recent findings LGIB primarily presents in the elderly, often on the background of comorbidities, and constitutes a significant healthcare and economic burden worldwide. Therefore, acute LGIB requires rapid evaluation, informed decision-making, and evidence-based management decisions. LGIB management involves withholding and possibly reversing precipitating medications and concurrently addressing risk factors, with definitive diagnosis and therapy for the source of bleeding usually performed by endoscopic or radiological means. Recent advancements in LGIB diagnosis and management, including risk stratification tools and novel endoscopic therapeutic techniques have improved LGIB management and patient outcomes. In recent years, the various society guidelines on acute lower gastrointestinal bleeding have been revised and updated accordingly. Summary By integrating the most recently published high-quality clinical studies and society guidelines, we provide clinicians with an up-to-date and comprehensive overview on acute LGIB diagnosis and management.

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“…In response to this need, recent advancements have focused on the application of plasmas generated in liquids, a field gaining attention due to its wide range of applications. One significant development is the creation of plasma scalpels for surgical use [8][9][10]. This technology requires submerging electrodes in saline solution; when an RF voltage is applied, low-temperature plasma can be generated near the electrodes.…”

Section: Introductionmentioning

confidence: 99%

An experimental study on low-temperature plasma tissue ablation and its thermal effect

Chen,

Xie,

et al. 2024

J. Phys. D: Appl. Phys.

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Low-temperature plasma ablation has been recently used for minimally invasive surgeries. However, more research is still needed on its generation process during tissue ablation and the underlying mechanism of tissue thermal damage. In this paper, high-speed camera footage, voltage-current signal collection, temperature analysis, and histological analysis were used to investigate the dynamic process of plasma tissue ablation and its thermal effect of dual-needle electrodes immersed in normal saline, which were driven by a high-frequency DC power supply with an output voltage ranging from 220V to 320V and a squire wave of 100kHz. Microbubbles occurred around the ground electrode and merged to form a vapor layer that could completely cover the ground electrode. Plasma capable of ablating tissue would occur in the vapor layer between the ground electrode and tissue. The effect of electrical parameters on plasma generation and its thermal effect are analyzed by statistical results. The experimental results indicated that the voltage applied to the electrodes significantly influenced both the generation and stability of plasma, as well as the heat generation and tissue damage around the electrodes. Furthermore, under the same voltage, the existence of biological tissue promotes the formation of a vapor layer around the electrode, thereby facilitating the generation and stability of plasma. Notably, the temperature rise around the ground electrode is much higher than that around the powered electrode. These results have direct application to the design of plasma tissue ablation systems, which could achieve tissue ablation effects with minimal thermal damage.

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Plasma Scalpels: Devices, Diagnostics, and Applications

Cited by 12 publications

References 57 publications

Electrosurgery for the Gynaecologist: Cutting and Coagulating with One Instrument and One Setting

Electrosurgery for the Gynaecologist: Cutting and Coagulating with One Instrument and One Setting

Diagnosis and management of acute lower gastrointestinal bleeding

An experimental study on low-temperature plasma tissue ablation and its thermal effect

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