Erbe ERBOTOM ICC 350 M, Instruction Manual

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4-11
Program E=ENDO CUT
ENDO CUT is a cutting mode in which the incision is automatically
controlled in such a way that alternating short, automatically
controlled cutting intervals result with defined pause intervals. In
this way a polypectomy loop, for example, cannot cut through a
polyp at just any speed, but rather at a controlled speed.
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.
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 endoscopic polypectomy of larger polyps as well as for
papillotomy. 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 ERBOTOM ICC 350 is also equipped in the ENDO CUT
mode with an automatic initial incision control which recognizes low-resistance loads and controls
the HF generator in such a way that it briefly provides enough power so that the initial incision
can proceed without delay. As soon as the initial incision has been made, the HF voltage for the
intensity of the electric arc required for the respectively selected cutting quality is automatically
controlled and the cutting procedure is automatically fractionated as described above. Thanks to
this device, the entire cutting procedure from the start to the finish of the incision is automatically
controlled. Additionally, this considerably reduces the average power during an incision as
compared to unregulated, nonautomatically controlled high-frequency surgery units.
Settings
AUTO CUT The HF power output for ENDO CUT can be limited in 1 watt steps from
200 watts to 1 watt . The LED for HIGH CUT is illuminated.
EFFECT can be set from 1 to 4.
AUTO COAG 1 This function field is not limited and all parameters can be set.
AUTO COAG 2 This function field is not limited and all parameters can be set.
AUTO BIPOLAR This function field is not limited and all parameters can be set.