Abstract
Problem
Traditional electrosurgical instruments are known to have an associated zone of thermal injury to the residual tissue. The compromised tissue left behind in the body may compromise wound healing and also may cause post operative pain. The PEAK PlasmaBlade is a new tissue dissection tool that uses pulsed radiofrequency energy to generate a highly focused plasma field at the tip of the device. This creates an effective cutting edge with simultaneous hemostasis while the blade remains near body temperature. A comparative study of tissue cutting and hemostasis was conducted to evaluate the characteristics of this technology.
Methods
Porcine mucosal and lymphoid tissue was subjected to a series of surgical incisions using the PlasmaBlade, a scalpel, a traditional electrosurgery (bovie) blade style tip, and a Coblation EVac 70 wand. Both low and high settings were evaluated for PlasmaBlade, bovie, and Coblation. Blood loss following the cut was evaluated. Histology samples were harvested immediately after and evaluated for collateral tissue damage at the incision site. Thermal imaging of all the devices in an active cutting mode was also conducted.
Results
Histological evaluation of the tissue samples showed that the PlasmaBlade cuts produced minimal collateral damage compared to cuts made with the other electrosurgical instruments, which demonstrated greater thermal damage. Bleeding control (hemostasis) was equivalent for the Plasma-Blade versus bovie and Coblation. Thermal imaging showed the PlasmaBlade operating in a range of 40 to 100 C which was similar to the Coblation operating temperatures. Traditional electrosurgery produced temperatures well in excess of 200 C.
Conclusion
The PEAK PlasmaBlade is a promising new instrument which provides atraumatic, scalpel–like, cutting and bovie-like hemostasis, resulting in minimal bleeding and tissue injury.
Significance
There is great potential for this becoming an important tool for common ENT procedures such as tonsillectomy and adenoidectomy, specifically in reducing the pain and morbidity of recovery.
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