maxium® smart C Electrosurgery Unit with maxium® smart Beam
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Revision 1
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Use only argon as working gas!
The pressure reducer can be connected to other pressure cylinders for so-called special gases such as
carbon dioxide as well! Make sure that the cylinder which the pressure reducer is to be connected to
really does contain argon. Appropriate cylinders are labeled with a band reading “ARGON”.
There are inert gas coagulation systems on the market which use helium as the working gas. This is not
possible with the maxium® smart Beam, since the gas flow regulation is calibrated for argon. When
connecting to a helium cylinder, which is mechanically possible, the actual gas flow would be higher by
several orders of magnitude than that displayed!
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Use only a pressure reducer by Gebrüder Martin!
The function and safety of the system are guaranteed only when a pressure reducer by
Gebrüder Martin is being used!
5.6.2
Embolisms and emphysema
Insufflation of gas into the operation field always entails the dangers of this gas being also blown into
transected vessels. This leads to danger of gas embolism. Although argon, in contrast to air or oxygen, does
not induce blood coagulation, argon gas bubbles in the arterial blood flow may, through the ramifications
of the vessels which become finer and finer, reach a point where they obstruct the flow of blood and can
stop it in the immediate environment. If the gas outlet at the tip of the applicator is placed directly upon
the tissue, there is the danger of injecting argon into the underlying tissue (emphysema).
In tissue structures where a skin layer is located above a closed tissue layer or which several layers of skin
overlay each other, argon may be insufflated between these layers, leading to separation of these layers
and trapping of larger quantities of argon.
To prevent this, observe the following rules:
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Never place the gas outlet of the applicator directly onto the tissue!
If the striking properties of the exiting beam are poor, then either select a higher output power setting
at the maxium® smart C electrosurgery unit or replace the applicator tip (burning down of the ignition
electrode tip).
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Do not use the maxium® smart Beam for hemostasis of larger transected vessels!
Such bleeding cannot be controlled reliably with the purely superficially active maxium® smart Beam
and must be dressed with conventional monopolar or bipolar contact coagulation, using a hemostat if
necessary.
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If possible, move the applicator so that it is not perpendicular to the tissue but rather forms an angle
between 30° and 60°. This will allow for a clarification of the operation field and reduce the likelihood
of argon penetration into the tissue.
5.7
Additional insufflation for endosurgical applications
Through the application of the maxium® smart Beam, argon is blown into the operation field. If the
operation field is located in a body cavity, then there is the danger that such gas insufflation leads to an
unacceptably high increase of internal pressure if the gas cannot escape. In particular in laparoscopic
surgery there is the risk of a collapse of the large venae cavae with the danger of circulatory failure if the
insufflation pressure exceeds the diastolic pressure of the relevant blood vessel.
