Erbe 10128-002, Instruction Manual

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4-1
4 DESCRIPTION OF THE HIGH-FREQUENCY SURGICAL UNIT
4.1 General description
Cutting with automatic control of the HF voltage (Auto Cut)
The ERBOTOM ICC is equipped with automatic open and closed loop control systems which
control and regulate the parameters relevant to the cutting quality so that each respectively selected
cutting quality is guaranteed to be reproducible and constant.
Adjustable power limitation in the cutting mode
Since the ICC units are equipped with automatic control of the HF voltage in the cutting mode,
a power setting in regard to cutting quality is not required. The adjustable power limitation is
primarily intended to guarantee the safety of the patient from unintentional thermal tissue damage,
and to protect fine cutting instruments, such as fine needle electrodes, from destruction due to
overly high HF currents if these come in contact in activated condition with other metallic
instruments. The latter, for example, is a risk during laparoscopic operations. This adjustable
power limitation must not be confused with the power setting for conventional high-frequency
surgical units, where the cutting quality is directly dependent upon the power setting.
PPS (Power Peak System)
The initial incision phase can represent a special problem during an incision, particularly if the
cutting electrode is firmly pressed against the tissue to be cut before activating the HF generator,
so that the cutting electrode has a relatively large-surface, and therefore low-resistance, contact.
This is the case, for example, for TUR and for endoscopic polypectomy. In such cases, the HF
generator must provide higher-than-normal power so that the initial incision can proceed without
delay, for otherwise a very large coagulation necrosis may result at the cutting location. The ICC
is equipped with an automatic power control which recognizes low-resistance loads and controls
the HF generator in such a way that it briefly provides enough power so that the HF voltage, i.e.
the intensity of the electric arc, required for the set cutting quality is ensured even for a low-
resistance load. Thanks to this device, the average power can be limited to relatively small
quantities, which corresponds to an improvement in protection from unintentional thermal tissue
damage.
ENDO CUT
A further special problem during endoscopic operations, for example during polypectomy and
papillotomy, consists in the fact that the electrodes used for cutting, for example polypectomy
loops and papillotomes, must be guided on long wire pulls through narrow working channels on
flexible endoscopes, and therefore the operator has no direct control over the cutting procedure.
However, particularly for polypectomy and papillotomy, a controlled incision is a requirement
in preventing complications. An incision that is too fast can lead to bleeding of the cut edges due
to lack of sufficient coagulation. An incision that is too slow can cause thermal damage, for
example to the intestinal wall.
For units equipped with a special cutting control (ENDO CUT), fractionation automatically
occurs in such a way through the incision that alternating short, automatically arc-controlled
cutting intervals with defined pause intervals result. In this way, for example, a polypectomy
loop cannot cut through a polyp at just any speed. The cutting speed and the degree of coagulation
for the cut edges is more uniform. ENDO CUT is additionally supported by PPS.
It is activated by footswitch.