GIMA SpA
DIATERMO MB250 – DIATERMO MB400
MA303IGBa-19-03-2007 Manuale
d’Istruzioni / Instruction’s Manual
34
stop the activation of the electrode when the tissue whiten to prevent to damage it.
maintain clean the point of the electrode(for this scope it’s advisable to use (for this scope it’s advisable using the
electrode cleaning sponges F7520);
Coagulation by fulguration or spray
The electrode is supplied by high voltages so that, with the electrode separated from the tissue, can be one or more electrical
arcs that die out in different places. The produced heat is so distributed on a surface of tissue bigger than it doesn’t verify in the
case of the single arc produced for the cut and that produces mostly coagulation. This method is ideal for the treatment of big
surfaces with a diffuse blood loss and superficial one (for example hepatic resection) and/or to realize coagulation at open
sternum in the cardiac-surgical.
Coagulation with anatomical forceps by the clamping
The more used coagulation consists to stop the haematic flow by the clamping pressure between the ends of the forceps.
After have clamped the portion of the tissue or the blood vessel seat of the coagulation, the active electrode puts in contact with
trhe proximal metal part of the forceps. The activation of the high frequency must be happen after this contact (forceps – active
electrode) to prevent faradic effect (primer of a electric flat that exploits like conductor the air) that would cause electrical
shock, burns to the operator, etc..
3.3 BIPOLAR CUT AND COAGULATION
In a different way from monopolar technic, with bipolar technic the portion of tissue interested by current passage in high
frequency is very small. In this technic the bipolar forceps are used (with different dimensions and shapes) on which distal
ends there are active and neutral electrodes. Clamping the interested tissue between the ends forceps, the current passage in
high frequency will happen from a end to another one, exploiting the portion of tissue to treat like an electrical bridge.
The bipolar cut consists in a dissection of the biological tissue by the passage of the high density current in high frequency
concentrated by the two points of the bipolar forceps. Lately there is a great interest for this method, above all for the
greater security offered and for the diffusion of the endoscopic and mininvasive surgical technics.
The bipolar coagulation is the haemostasis of small blood vessels of the body tissue between the two points of the forceps.
When the current density is reduced the consequent effect is the desiccation of the cellular surface, without penetration in
depth, with consequent coagulation.
The bipolar technic is extremely more safe because the current direction in high frequency is always determinated and not has
unknown factors and probable erroneous directions, and the used powers are lower than those used in monopolar technic. For
these reasons this technic is used above all in the more critical surgical operations, so it’s important to maintain clean the distal
ends of the forceps during the operation, because they are subject to accumulation of coagulated tissue, that limits the current
passage and favours the sticking of the tissues.
The application of the neutral electrode (used obligatorily in the monopolar technic) isn’t necessary, even if in a practical point
of view it’s always advisable the application on the patient during the initial preparatory phase.
