Sei sulla pagina 1di 14

Monopolar surgery

RF current flows through ESU and active electrode.


Returns to ESU through return electrode .
Used for cutting and coagulation.

Monopolar Cut
1 und Cut 2

Combined
Power setting

Connection for
single and dual
pad neutral
electrodes
Connection for
monopolar
handles

ME 82

monopolar
Contact Coag
and Spray
Coag
Bipolar
Coagulation

Combined
One-pedalFootswitch
Bipolar jack for
Instruments

Monopolar Application:
2 cutting currents:
Smooth cut without scab
Ohm

80 Watt at 300

Cutting with some scab formation


Ohm

70 Watt at 300

2 Coagulation currents:
Coagulation with deep effect when in
Ohm
contact with the tissue

70 Watt at 200

Spray Coagulation
Ohm

60 Watt at 400

Coagulation current for superficial coagulation


of tissue with sparks (Fulguration)

Monopolar Application:
Combined Rotary Knob
one rotary knob for all operating modes (also
bipolar)
fast and easy power settings, no touch buttons!
technically simple; very easy to understand
power adjustment linear with angle of rotation

Monopolar HF power-output-jack
Big Coax-jack, suitable for :
handle with only one finger button
handle without finger button in combination with a
foot
switch

Monopolar Application:
Always use with a neutral electrode!
4 NE-Types can be connected and monitored:
one pad neutral electrodes

dual pad neutral electrodes

disposable or
reusable

Safety circuit of the NE:


Single pad
NE

Dual pad NE

The HF-current switches off


automatically to prevent from
burns if the circuit to the NE is
interrupted

Additional safety circuit thanks to


PCS-function (Patient Control
System) Application Monitoring

NE-Monitoring using dual-pad


NEs:
Monitor
Output
Signal

ALARM
ON

Alarm
threshol
d

ALARM OFF

time

Monopolar Application:
Circuit mode BF
Warning:
Patient must be
Insulated against earthgrounded metal parts of
the OP-table!!!

Optimal
Setup:
Patient
Polster
OP-Tisch

Surgical Effects of Electrosurgery:


Coagulation effect:
effect

Cutting effect:

Contact Coagulation
Active-electrode or instrument is
in direct contact with physiological
tissue
Effect is achieved by conversion of
electric energy into thermal energy

B Spray Coagulation /
Fulguration
Active-electrode is not in
contact with physiological tissue
Superficial coagulation achieved
by spark formation

!
!

mechanical separation
! No
of tissue,
The Cut-effect is achieved
by high energy
concentration at the tip of
the active electrode

Surgical Effects of RFSurgery


Cutting effect:
40o
C

1. Hyperthermia
2. Edema formation
3. Coagulation
4. Tissue cooking
5. Dehydration
6. Tissue burns
7. Formation of Burn
Scabs
8. Carbonisation

Monopolar
Application:
RF-Unit = Generator
Neutral-Electrode
large contact area

Active-Electrode
small contact area

Floating
Output
RF-leakage Current
Isolatr
HF-Current

Attention!
Always
insulate
patient
towards
grounded
metal parts!

Ideal Set-up:
Patient
Drapes
Film
OP-Table

The Application of the Neutral Electrode must be correct,


otherwise there is a risk of burns!!!

Monopolar Current Forms

7 different Current modes for most surgical indications


Monopolar- Cut 1
Pure Cutting Current allowing
smooth cuts;
with optional integration of an
overshoot cut pulse

Monopolar- Cut 2
Cutting current blended with
coagulation current.

Monopolar Cut Uro 1


Cutting Current allowing smooth
cuts in liquid media (e.g. TUR)
with optional integration of an
overshootcut pulse

Monopolar Cut Uro 2


Cutting current blended with coagualtion
current to be used in liquid media,
e.g. Papillectomy

Contact Coagulation 1
Coagulation current with very deep
reaching effects; to be used in direct
contact with the tissue

Contact Coagulation 2
Coagulation current with deep
reaching effects; to be used in
direct contact with the tissue.
Suitable for TUR.

Spray Coagulation
Non-contact surface coagulation
(fulguration). Under liquid media
in contact useful for staunching
the blood flow when small-surface
electrodes are used in TUR

Current Form URO = Applications under


Water

URO Cut 1
Cutting current allowing
smooth cuts in liquid media
(e.g. TUR);
with optional integration of a
overshoot pulse

URO Cut 2
Cutting current blended with
coagualtion current to be
used in liquid media,
e.g. Papillectomy

Five current modes:


Cut I

: Unmodulated HF-current for smooth cutting (and

contact

Cut II
formation in
bleeding

Contact Coag
coagulation of

Spray Coag
sparcs

coagulation if necessary)
Modulated HF-current for cutting with scab
tissue or fat tissue that is usually heavily

: Strongly modulated HF-current for contact

already bleeding tissue


: Coagulation current superficial coagulation with

(Fulguration).

Bip. Koagulation : The HF-current is adjusted to the different


conditions of

the bipolar technology

Optional activation per hand or footswitch


Safety circuit for the neutral electrode

Neutral electrode connector / floating output.


The neutral electrode is fully isolated from ground, at high
as well as low frequencies.
Symbol denoting class of equipment; CF = cardiac
floating. The system is defibrillator-proof, which means
that it can be used directly on the heart.
WARNING!
Means "Observe Operating Instructions!"
WARNING - HIGH-FREQUENCY CURRENTS
CAUTION - HIGH VOLTAGES!