SECTION 6 DURING SURGERY
Gyrus ACMI PlasmaKinetic SuperPulse Generator (Endourology)
USER MANUAL
Part Number: 144020-LB
Page 6-2
increasing the selected power output setting of the SuperPulse Generator by 25% during the first 400
milliseconds of cut activation, up to a maximum output of 200W.
Use of Default Mode Settings
Similar to power settings, the mode selection for procedures vary considerably both with the
surgeon’s technique and the configuration of the active instrument. The PlasmaKinetic
instruments
are unique to the type of procedure being undertaken and may require some experience before the
effects of the different mode settings become apparent.
PlasmaKinetic
(PK)/SuperPulse (SP) Modes:
The three PK/SP mode levels adjust the tissue effect of the output: PK3/SP3 > PK2/SP2 > PK1/SP1,
the more aggressive tissue vaporisation produced by a PK3/SP3 selection. More aggressive tissue
vaporisation will produce more vapour bubble formation.
CAUTION
The formation of vapour bubbles may obscure visualisation during activation
particularly when operating in a very confined space or during reduced irrigation
flow. Use caution when adjusting the PK/SP modes in these circumstances.
ThermoKinetic (T and TS) Modes:
Two of the ThermoKinetic outputs are available for use with all PK instrument configurations. These
are indicated as ‘T1’ and ‘T2’ on the power setting display. In both options, the output is automatically
switched between PlasmaKinetic
and Desiccate modes to produce more haemostasis than the pure
PK outputs, while still providing tissue vaporisation. ThermoKinetic 1 (T1) switches between PK2 and
DES five hundred times per second while ThermoKinetic 2 (T2) alternates between PK3 and DES
approximately thirty times per second. The actual tissue effects observed with T1 and T2 are to a
large degree dependant on the nature of the tissue being treated. As a generalisation however, T1
produces a superficial blanching of tissue with little to no vaporisation while T2 produces a level of
vaporisation equivalent to PK1 with an enhanced haemostatic effect. Instruments that use the SP
mode also have access to two additional ThermoKinetic outputs, indicated as ‘TS1’ and ‘TS2’ on the
power setting display. The method for providing increased hemostasis with these outputs relies on
selectively modulating the SP2 output at half-millisecond steps when contact with tissue is detected.
The TS2 has a higher crest factor than the TS1 output and so provides more hemostasis. A vibration
may be mildly discernable, indicative of this process.
Desiccate (DES) Mode:
The DES output is available with all PK instrument configurations. The haemostatic effect will be
dependent on the active instrument contact area and power setting. The output is specifically
controlled to prevent vaporisation from occurring and to provide a soft coagulation effect. The depth of
effect for a given PK instrument configuration and power setting will be dependent on the application
time.
Activation: Output Selection
In common with conventional electrosurgical generators, output activation is achieved using the blue
and yellow pedals of the footswitch.
BLUE PEDAL: Desiccate only. Activation accompanied by flashing of the desiccate power display and
an audible tone.
YELLOW PEDAL: PlasmaKinetic
1, 2, 3, SuperPulse 1, 2, 3 and ThermoKinetic T1, T2, TS1 and
TS2 depending on output mode selection. Activation is accompanied by flashing of the SP/PK or T
power display and a higher pitched audible tone than the desiccate activate tone.
IMPORTANT
Familiarise yourself with the two audible output tones to verify output selection as it
is often difficult to visualise the footswitch pedals during surgery.
SECTI
O
N 6
DURING SURGERY
Summary of Contents for PlasmaKinetic
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