gāo pín diàn dāo
2 English Referenceendotherm knife
electric knife
The high-frequency electrosurgical knife (HF scalpel) is an electrosurgical instrument that replaces the mechanical scalpel for tissue cutting. It heats the tissue when it comes into contact with the muscle through the high-frequency, high-voltage current generated at the tip of the effective electrode, which achieves separation and coagulation of the muscle tissue, thus serving the purpose of cutting and hemostasis.
The high-frequency electrosurgical knife has a history of more than 70 years since it was first used in clinical practice in 1920. It has experienced a spark plug discharge - high-power electronic tube - high-power transistor - high-power MOS tube four generations of change. With the popularization, application and development of computer technology, at present, high-performance microcontroller is widely used in the high-frequency electrosurgical knife machine control, the implementation of a variety of functions under the power waveform, voltage, current, automatic adjustment, a variety of safety indicators, as well as the detection of programmed control and fault detection and indication. Thus, it greatly improves the safety and reliability of the equipment itself, and simplifies the operation process for doctors.
At the same time, with the development of medical technology and clinical requirements, high-frequency scalpel-based composite electrosurgical equipment has developed accordingly: high-frequency argon knife, high-frequency ultrasound surgical system, high-frequency electrocutaneous endoscopic treatment system, high-frequency rotary cutting and degreasing machine and other equipment, in the clinic have achieved remarkable results. And with the derivation of a variety of high-frequency surgeon special accessories (such as: bipolar electrocutaneous scissors, bipolar electrocutaneous mirrors, electrocutaneous mirrors, vaporizing roller electrodes, etc.) has also developed a wider scope of use for clinical surgery.
3 Classification of high-frequency scalerAccording to the function and use of high-frequency scaler, can be roughly divided into the following types:
1, multi-functional high-frequency scaler: with a pure cut, mixed cuts, unipolar electrocoagulation, electrocautery, bipolar electrocoagulation;
2, unipolar high-frequency scaler: with a pure cut, mixed cuts, unipolar electrocoagulation, electrocautery;
3, bipolar coagulation: bipolar electrocoagulation;
4, electrocautery: unipolar electrocautery;
5, endoscopic special high-frequency generator: with pure cut, mixed cut, unipolar electrocoagulation;
6, high-frequency argon knife: with argon protection cutting, argon arc jet coagulation;
7, multifunctional high-frequency cosmetic instrument: with a point of coagulation, point of cauterization, ultra-high-frequency electrocautery.
The basic composition of high-frequency scalpel
High-frequency scalpel is composed of the host and scalpel handle, patient pole plate, bipolar forceps, foot switch and other accessories.
Working principle of HF scalpel
HF scalpel has two main working modes: unipolar and bipolar.
1. Unipolar Mode
In the unipolar mode, tissue is cut and coagulated with a complete circuit consisting of a high-frequency generator within the HF scalpel, a patient pole plate, connecting wires, and electrodes. In most applications, the current passes through the patient through the active wires and electrodes, and returns to the HF generator from the patient plate and its wires.
The heating effect of the HF scalpel, which destroys diseased tissue, is not caused by heating the electrodes or the tip, as in an electrocautery burner. It is a collection of high-frequency currents of high current density that directly destroys tissue that is under a point of contact with the tip of the active electrode. Coagulation occurs when the temperature of the tissue or cell in contact with or adjacent to the effective electrode rises to the point where the proteins in the cell are denatured, and this precise surgical effect is determined by the waveform, voltage, current, type of tissue, and shape and size of the electrode.
To avoid burning the patient by continuing to heat the tissue as the current leaves the patient and returns to the HF generator, the patient's plate in a monopolar device must have a relatively large area of contact with the patient to provide a low impedance and low current density pathway. Some high-frequency electrocautery machines used in physician offices have low current and low density and can be used without a patient plate, but most general-purpose high-frequency electrocautery machines use higher currents and therefore require a patient plate.
A ground-isolated output system removes the need for an auxiliary pathway between the HF scalpel current and the patient and earth, reducing the risk of burns to body parts that may come into contact with grounded objects. In contrast, with a ground-based system, the risk of burns is greater than with an insulated output system.
2, bipolar mode
Bipolar electrocoagulation is to provide high-frequency electrical energy to the body tissues through the two tips of the bipolar forceps, so that the blood vessels between the ends of the bipolar forceps are dehydrated and coagulated, to achieve the purpose of stopping bleeding. Its scope of action is limited to between the two ends of the forceps, the degree of damage to the tissues of the body and the scope of influence is much smaller than the unipolar method, suitable for small blood vessels (diameter <4mm) and fallopian tube closure. Therefore, bipolar electrocoagulation is mostly used in brain surgery, microsurgery, otolaryngology, obstetrics and gynecology and hand surgery and other more delicate surgery. The safety of bipolar electrocoagulation is gradually recognized, and its use is gradually expanding.
4 UsesAt present, not only in direct vision surgery, such as general surgery, thoracic surgery, cerebral surgery, orofacial surgery, maxillofacial surgery has been widely used, but also more and more in a variety of endoscopic surgery, such as: laparoscopy, prostatectomy, gastroscopy, cystoscopy, hysteroscopy and other surgical procedures.
Because the high-frequency scalpel can simultaneously cut and coagulation, in the mechanical scalpel is difficult to access and implementation of the operation (such as: abdominal tube ligation, prostate urethral mass removal) to be commonly used.
The outstanding coagulation effect of the HF knife makes it widely used in diffuse bleeding sites such as liver, spleen, thyroid, breast, and lung surgery.
5 Other functionsA comprehensive performance of the high-frequency scalpel in addition to the basic functions of surgery, there are several important functions:
1, the output power indication;
2, the power preset, adjustment;
3, the patient's polar plate detection alarm;
4, the work of the audio instructions;
5, the output of the port anti-error insertion function;
5, output Port anti-error insertion function;
6, hand control, foot control function.
6 Advantages of high-frequency electric knife1, fast cutting speed, good hemostatic effect, simple operation, safety and convenience.
2, compared with the traditional use of mechanical scalpel, the use of high-frequency scalpel in the clinic can greatly shorten the operating time, reduce the amount of blood loss and blood transfusion of the patient, thereby reducing complications and surgical costs.