Erbe ERBOTOM ICC 350 M, Instruction Manual

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4-2
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.
Soft coagulation
Soft coagulation can be activated by key or pedal. It is especially advantageous for use in
combination with the Auto Stop mode available in the ICC. Here, the coagulation process is
automatically stopped as soon as the electric resistance of the coagulum increases due to vapor
formation. In this way, the coagulation process is prevented from stopping too early or too late.
If the coagulation process stops too early, coagulation may be insufficient. If coagulation is too
long, the coagulum can dry out and adhere to the coagulation electrode.
Forced coagulation
Forced coagulation is advantageous if an efficient hemostasis is to be achieved with relatively
small-surface electrodes, such as TUR resection loops.
Spray coagulation
The Spray coagulation mode on the ICC is also suitable for Argon Gas coagulation.
Adjustable power limitation in the various coagulation modes
For the ERBOTOM ICC units, the surgically relevant coagulation qualities, i.e. the coagulation
effects Soft Coag., Forced Coag. Spray Coag. and Bipolar Coag., are delimited by definition
from one another and selectable by the press of a key. Nevertheless, the intensity of the different
effects can be varied by power limitation.
The Soft, Forced and Spray modes are each doubly available
In this way, two different coagulation modes can be preset independent of one another and, if
two coagulation instruments are used, applied independent of one another, although not
simultaneously for reasons of safety. Thus for example one coagulation instrument can be
connected and applied to Soft coagulation and another instrument to Argon Plasma coagulation
on the same ICC 350.
Bipolar coagulation
In this coagulation mode, the HF voltage is, similar to Soft coagulation, automatically and
constantly controlled, and its peak value always remains lower than 200 Vp, so that the current
density and thus the coagulation effect is, for the most part, independent of the effective contact
surface between the coagulation electrode and the tissue, provided the effective contact surface
is not too large relative to the currently set power limitation.
The adjustable power limitation serves the purpose of protecting fine bipolar coagulation
instruments, such as pointed bipolar coagulation forceps, from being thermally destroyed in
case of a short between the two forcep tips.