maxium® smart C Electrosurgery Unit with maxium® smart Beam
104
Revision 1
Neptun
Neptun is a bipolar current type for fluid-assisted coagulation (EHT method = electrohydrothermosation)
Preferentially, isotonic saline solution is fed to the instrument tip through the flushing channel(s) of a
bipolar instrument and dropwise applied to the tissue to be coagulated. When the electrodes come into
contact with the tissue, only a small amount of HF current flows through the tissue itself; the larger amount
of HF energy heats the electrically conductive saline solution. The coagulation effect is based on the liquid
thus caused to boil. The resulting temperature is limited to the boiling temperature of water (approx. 100°C
[212°F]), which avoids carbonation of the tissue. A large amount of energy is used for the vaporization of
flushing liquid. Thus an output of 120–180 W must be set for the generator, depending on the supplied
amount of liquid and the selected electrode size. Using the effect setting, the voltage can be changed and
thus the hemostatic effect slightly varied.
This method has been tried and tested particularly in the field of parenchyma surgery (liver, spleen,
kidney). However, it can also be beneficial in other applications in visceral surgery or neurosurgery.
The supply of liquid before coagulation allows the origin of the bleeding to be localized more easily.
Bleeding tissue is not carbonated and the traumatized wound area is smaller.
No coagulated tissue can stick to the active HF electrode, and therefore the inherent risk of initiating
secondary bleedings is avoided.
This type of current can also be applied without supply of liquid. In this case, the generator output must be
adjusted to 40–60 W. The start delay for
Auto Start
can be varied, see section 10.3.4 “Selecting the
Activation Type/Foot Switch”, page 55.
Risk of property damage!
When putting the instrument down in auto-start mode, ensure that the instrument tip does not come into
contact with a cloth soaked in liquid.
Risk of injury!
•
For laparoscopic/endoscopic applications, the instrument may not be used in auto-start mode.
For further information, refer to section 9.7, page 51, and section 5.8.1, page 27
•
Arcing can occur in case of bipolar electrodes arranged in relative close vicinity. Arcing can occur
especially when lifting up the instrument while a current or the generator is active and there is no
contact to tissue/liquid.
Active accessories to be used with this current must be able to withstand an HF voltage of at least 240 V
(depending on the selected effect).
