16
b. Equivalent Fully Rectified - Low lateral heat.
c. Equivalent Partially Rectified - High lateral heat.
d. Equivalent Fulgurate Rectified - Highest lateral heat.
E
Frequency - The higher the frequency, the less lateral heat produced.
6.2
WAVEFORM
6.2.1
Fully Filtered Wave - CW
The Fully Filtered Waveform is a pure continuous flow of high-frequency waves. This filtration
results in a continuous non-pulsating flow of waves which provides a micro-smooth cutting flow.
Under many clinical conditions, this feature is most advantageous. This wave produces the least
amount of lateral heat and tissue destruction.
6.2.2
Fully Rectified Modulated Wave
The Fully Rectified Modulated Waveform produces a minute but perceptible pulsating effect which
can, under certain conditions, slightly reduce the efficiency of the cutting effect. In addition to a
smooth cut, the Fully Rectified Modulated Wave is accompanied by a very slight superficial
coagulation on the raw cut tissue surfaces. When the tissue is areolar, a perceptible film of
coagulum forms along the surface of the coated margins as the tissue heals. The coagulum does
not interfere with normal healing by primary intention, and peels off spontaneously when the
healing is complete.
6.2.3
Partially Rectified Modulated Wave
The Partially Rectified Modulated Waveform is an intermittent flow of the high-frequency waves in
producing hemostasis, and it is highly effective in sealing off bleeders up to 1/16 inch in diameter
eliminating the need to tie them off. The Partially Rectified Modulated Wave is also recommended
for the indirect technique where one can coagulate blood vessels by grasping a hemostat and
lifting free of surrounding tissues. An electrode is then brought into contact with the hemostat, 1
or 2 inches from its tips. When the Partially Rectified Modulated Waveform is turned on, the walls
of the vessel will be sealed making ligation unnecessary.
6.2.4
Fulguration
The Fulguration or Spark-Gap Wave is a mutated electronic current that has been weakened to
simulate the effects of the Oudin current. The Fulguration current produces a potent dehydration
effect on tissues. Its destructiveness is self-limiting because of the air space the sparks must jump
and because of the insulting effect of the carbon or eschar and the movement to prevent
cumulative heat destruction.
6.3
PRE-OPERATIVE CUTTING PRACTICE
Since radiosurgery requires virtually no pressure to effect a cutting action, the hand should rest on some
support in order to retain good control over the instrument. The ingredients for efficient radiosurgery are a
gentle touch, digital dexterity, a fluid wrist action, and a feather-light touch. The tissue to be cut should
be moist. If it is too dry, surface charring will occur. Excessively dry tissue can most easily be
moistened with a wet gauze. Prior to performing an operative procedure, the area should be studied in
order to select the correct electrode, waveform and power. Several practice strokes, with power off, are
recommended to determine the correct length, depth, and direction of cut. Prepare the Surgitron 4.0 Dual
RF/120 IEC for operations as described in PREPARATION FOR USE, then follow the steps below.
6.3.1.1 Select a piece of fresh, lean beef containing very little fat. Do not use veal because it does
not change color when cut with an electrode. Allow meat to reach room temperature.
6.3.1.2 Place the meat on the Neutral Plate.
6.3.1.3 Insert the electrode of choice (Straight, Loop, Diamond or Vari-Tip) into the handpiece.
6 . 3 . 1 . 4 Select "CUT" by pushing "SELECT" button on the Cutting Mode to turn on the CUT indicator.
