Utah Medical Products FINESSE +, Руководство по обслуживанию

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Service Manual
3
the process of the practitioner developing his/her own techniques. Some of these will be given in
this manual.
The output level settings appropriate for the various electrosurgical procedures are the first and
most important parameters to be determined by the practitioner. The settings used by the devel-
opers of these techniques are given in their published papers. (Some of these papers are listed in
the Bibliography section of this manual.) However, these published results were obtained using
different electrosurgical generators. Every generator has its own cutting characteristics that may
not be exactly duplicated by another generator using the same settings. Furthermore, the charac-
teristics of the excision are dependent not only upon the output setting, but also upon the length
and thickness of the cutting electrode, the moisture content and type of tissue, and the speed of
the cut.
Always use the lowest possible setting which achieves the desired excision quality
and speed.
The new user should develop confidence in the combination of the generator's characteristics and
his/her own technique by practicing extensively on pieces of chicken breast or beef tongue. The
objective of this practice is to determine the natural speed of the cutting electrode through the
tissue at various output settings, and to observe how the depth of the thermal damage is influ-
enced by the speed of the cut, the cut or blend mode selected, and the output setting used. After
sufficient practice is obtained, the clinician should be able to develop the confidence and skill
necessary to practice these procedures on patients using electrodes of different sizes and configu-
rations for various procedures. Practitioners who prefer a slow cut, using a small electrode, or
excising a small amount of tissue should use settings at the lower end of the output range. Those
who prefer a faster cut, using a large electrode, or excising a large amount of tissue should use
settings at the upper end of the output range. The cutting power required is dependent on many
factors such as:
1. Nature of tissue to be excised. Fatty or cartilaginous tissues require higher power output than
muscle or skin tissue. Sclerotic, fibrotic, or cicatrical tissues require higher power output than
softer tissues.
2. Depth of excision. A deep excision (with the same electrode and speed of cut) requires a
higher power output than a shallow incision.
3. Rate of speed at which the cutting electrode is moved. The faster the speed of the wire
through the tissue during the cut requires higher power outputs than at slower speeds.
4. Type of electrode used. For a given depth of excision with an equivalent cutting speed, the
longer wire requires higher power outputs than a shorter wire. Thicker wire requires higher
power outputs than a thinner wire.
5. Tissue moisture content. Drier tissue requires higher power output than moist tissue.
The generator diminishes the effects of some of the above variables by means of its
feedback-controlled output. Because this circuit reduces the output power applied at the begin-
ning and end of the cut to the minimum levels needed, it is generally operated at somewhat high-
er nominal output settings than most generators. The pure cut mode provides an excision with
little hemostasis effect. Blend 1 provides an excision with minimal hemostasis effects. Blend 2