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ESU-X 500TT_EN B
01.06.15
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Remember that, mainly when high powers are used, if a “Split” NE is not used, the control circuit of the
unit
can’t verify the contact between the NE and patient’s tissues; that is, it does not guarantee the
intended safety.
When fixing a “Split” NE, set it to obtain the same distance between both the parts of the NE and the
operation area (i.e. when intervening on the abdominal area, if the NE is on the thigh, place it lengthwise
on the leg).
As the space between the NE and the operating area represents a sort of “path” for the HF current, be
sure that it does not across diagonally the body or it crosses the heart.
USE OF CURRENTS AND POWERS
Check the features of its currents before using a new HF unit without considering the previous
experience with similar devices. Anyway, always start an operation with very low powers and then raise
them until the required result is reached.
Always use the lowest possible power. Do not exceed 1/4 of the maximum power of monopolar currents
when using neutral electrodes for pediatrics, or 1/6 when using neutral electrodes for new
‐
born.
Use the bipolar mode when operating on delicate or much innervated tissues, on small portions of tissue
or cavities, on patients with pace
‐
makers or similar devices and when the use of the neutral electrode is
difficult.
Remember that the use of too low powers can cause unexpected risks.
USE OF ACTIVE ACCESSORIES (ELECTRODES, PENCILS, INSTRUMENTS, CABLES, CONNECTORS)
Never use accessories (active electrodes, pencils, instruments, cables, connectors):
Not compliant with all the applicable technical / legislative Rules (I.E. Not EC approved)
Not well working or with damaged insulations (The bad insulation is the cause of the burns on the hand
of surgeons) and worn or dirty because they do not guarantee the safety, because they produce useless
superficial sparks and they cause an unstable functioning which can lead operators to increase powers
to dangerous levels. Always check them before the operation, mainly if they are for endoscopy.
Not suitable for the working voltages of the device:
Approx. 7600 Vpp. “4000 Vp” for the monopolar currents with crest factor equal or higher than 2.
Approx. 3600 Vpp “1800 Vp” for the monopolar currents with crest factor lower than 2.
Approx. 1100 Vpp “550 Vp” for the bipolar currents with crest factor equal or lower than 2.
When positioning the cables of the electrodes, avoid their contact both with the patient and with other
cables or conductive parts. During use, place unused electrodes or instruments on insulating materials.
If the carbonization of the tissues is not required, do not activate the monopolar currents (mainly the
currents for coagulation with high sparking) if the electrode does not touch the tissue.
The standard monopolar pencils are suitable to connect electrodes with stem Ø 2,3 mm.
SPECIFIC USE OF THE MONOPOLAR AND BIPOLAR INSTRUMENTS FOR LAPAROSCOPY
Use the instrument under visual control and, after each withdrawal, check that all parts are present.
Maintain a correct distance between the ends of the instrument and sensitive structures of the tissue.
Activate the current only if the ends of the instrument are in contact with the tissues to cut
/coagulate/seal. Never use, during the operation, a hot instrument (it means an instrument with hot ends)
for preparation.
Never use currents with automatic start/stop system.
SPECIFIC USE OF THE BIPOLAR INSTRUMENTS FOR VESSEL SEALING
In addition to the previous warnings, when using the instruments, mainly if for laparoscopy, prudentially
perform at least 2 seals (to the left and to the right of the point to cut) and verify if vessels are well
coagulated / sealed before cut it.
About the sticking of the tissue on the ends of the instrument, see the specific advices under detailed.
INFORMATIONS FOR THE BIPOLAR USE
USE OF BIPOLAR SCISSORS
Coagulate tissues by using “
BLEND BICUT”
or “
MICRO
”
currents while cut them mechanically.
STICKING OF THE TISSUE ON THE TIPS OF BIPOLAR INSTRUMENTS
The sticking of the tissue on the tips of forceps/clamps is a normal a problem while using the bipolar currents for
coagulation and vessel sealing. To reduce it do the following:
When using forceps/clamps, irrigate , if possible, tissues with physiological solution.
Use all forceps/clamps damp or wet by physiological solution their tips. For example:
Damp tips before the use by a gauze and damp them again after 3 / 4coagulations.
Immerse tips in a bowl and wet again them in the same way after 3 / 4coagulations.
