Electrocoagulators, EHVCh, electrosurgical high-frequency systems – all these are the names of surgical devices for tissue dissection and quick stop
Choosing an electrocoagulator: what to look for?
Electrocoagulators, EHVCh, electrosurgical high-frequency systems – all these are the names of surgical devices for dissecting tissues and quickly stopping bleeding.
Modern electrocoagulators are actively used in various fields of medicine:
- general surgery,
- pediatric surgery,
- cardiac surgery,
- thoracic surgery,
- visceral surgery,
- neurosurgery,
- gynecology,
- urology,
- gastroenterology,
- traumatology, etc.
The scope of application largely determines the choice of an electrosurgical high-frequency system, as well as such characteristics as:
- device cost,
- its manufacturer
- exposure modes,
- current power,
- waveforms,
- pulse frequency variations,
- design of ECHF instruments
- quality and composition of electrodes,
- the number of simultaneously used electrodes,
- Software and automation capabilities,
- polarity reversal options,
- other specifications.
Let's consider the main ones.
Manufacturers and cost of electrocoagulators
There are quite a few manufacturers of coagulators – among them are Russian, European, and Asian companies.
It should be noted right away that foreign EHVCh manufacturers provide customers with a wider and more diverse range of devices, but the price of such coagulators is quite expected (and justifiably) higher than the cost of Russian analogues.
The less budgetary cost of foreign EHVCh devices includes the price of technological developments and innovations. High technology, ergonomics, reliability and quality of such products make them more expensive and competitive.
Separately, I would like to note the highest functionality of foreign coagulators, which implies a full range of cutting and coagulation modes. The flexibility of universal EHVCh devices makes them very popular.
But do not think that with a limited budget, a foreign-made electrocoagulator will not be available to you. Almost any line includes EHVCh devices for various purposes and functionality: from the simplest models for cosmetology to multifunctional systems.
One of the leading manufacturers of electrosurgical systems is the German company BOWA, known worldwide for its reliable, safe and functional electrocoagulators.
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| Bowa ARC 100 electrocoagulator for ENT surgery, minor surgery, cosmetology with a maximum power of 100 watts and the possibility of special settings. | Bowa ARC 250 electrocoagulator for urology, neuro-, plastic, general and pediatric surgery, otorhinolaryngology, gastroenterology, dermatology. | Bowa ARC 303 electrocoagulator is a multifunctional device for orthopedics, cardio-, thoracic and general surgery, urology, gynecology. |
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| Universal electrocoagulator Bowa ARC 350 with a high level of power for gynecology, urology, cardio-thoracic and general surgery. | Bowa ARC 400 electrocoagulator for urology, gynecology and surgery with ligation technology and the possibility of personal settings. | The Bowa ARC Plus electrocoagulator is a special unit for ARC 400 and ARC 350 EHVCh devices for argon plasma electrosurgery. |
Principle of operation and main modes
The essence of the operation of the EHVCh apparatus is the conversion of high-frequency current into thermal energy. The instruments used – active and neutral electrodes – when in contact with the patient's tissues, form a complete closed electrical circuit.
Various types of EHVCh cutting or coagulation, devitalization (destruction) of tissues, thermal sealing (ligation) of vessels are available to the user.
The type of impact is determined by temperature.
Tissue temperature
Effect
- Devitalization
- Coagulation of intracellular proteins
- Coagulation of extracellular collagen
- Destruction of cell membranes
CUTTING is understood as the process of tissue dissection by supplying a high-density high-frequency current to the point of application of the active electrode.
The effect of COAGULATION is achieved by converting electrical energy into thermal energy and heating tissues to a temperature of 60-100 degrees. Intracellular and extracellular fluids are evaporated, while the destruction of cellular structures does not occur.
DEVITALIZATION is used to purposefully destroy abnormal tissue or tumors. Already at a temperature of 50-60 degrees, irreversible destruction of the cell begins, and the devitalized tissue is split due to metabolic processes.
LIGATION – the most popular method of bipolar coagulation, which means sealing the vessel. An “interrogating” pulse of high-frequency current is applied to the section of the vessel captured by the electroligator, which measures the resistance of the squeezed walls of the vessel. Having received the data, the electrocoagulator generates a signal of the required strength, which dries up the vascular collagen. The cyclic repetition of the process occurs until the vessel walls are completely sealed.
EKhVCh provides the adjusted force of mechanical squeezing of a vessel and control of supply of current.
The advantages of the ligation mode are:
- high speed procedure
- no costs for additional accessories (clips, clips, suture material)
- ability to work with large vessels
- process automation
- reducing the risk of medical error during surgery
Obviously, the ligation function significantly increases the price of the coagulator.
Methods of electrosurgical exposure
The main issue that you need to decide before buying an EHVCh device is the modes of exposure. The mode can be:
- monopolar
- bipolar
- combined.
The mode not only determines the cost of the EHVCh apparatus (the price of combined coagulators will certainly be higher), but also the possibilities of application.
Monopolar coagulators high-frequency current is passed along the shortest path: from the active electrode to the neutral one through the patient's body, and the effect is due to the active electrode.
Monopolar coagulation is used for open interventions and provides a greater depth of manipulation, where high power is needed – up to 250 watts.
Bipolar coagulation implies the passage of current not through the patient's body, but from one electrode to another. Localization of the current occurs directly at the point of impact without damaging the surrounding tissue. Bipolar coagulation is distinguished by the minimum values up to 0.1 W that the device can transmit, and is indispensable in neurosurgery, gynecology, liver surgery, etc.
Argon plasma coagulation
Separately, it is worth noting the method of NON-CONTACT coagulation, which is possible due to the use of inert argon. In certain pathologies, the absence of contact between the electrode and tissues is a fundamentally important point! This is especially in demand during manipulations on the mucosa, as well as operations with heavy diffuse bleeding.
Argon plasma coagulators are indispensable for:
- otorhinolaryngology
- gynecology
- various areas of surgery, incl. liver surgery, transplantation and abdominal plastic surgery,
- interventional bronchoscopy,
- therapy with flexible probes.
Argon plasma arising as a result of the ionization process provides:
- rapid hemostasis of a large surface,
- high positioning accuracy,
- excellent visualization,
- impact control,
- thin eschar without carbonation effect,
- low level of postoperative complications.
The choice of an electrocoagulator depending on the needs of a medical institution
Of course, the activity of a clinic or center largely determines the choice of a coagulator. Therefore, it is worth paying attention to the frequency of exposure to biological tissue: the higher the frequency of exposure, the more pronounced the cutting effect and the less pronounced the coagulation effect.
For plastic surgery, an ECHF device with a higher frequency (2.64 – 5.28 MHz) is suitable, as well as separate cutting and coagulation modes, because. in this case, it is especially important to minimize the appearance of scars.
Gynecology and otorhinolaryngology usually need stronger coagulation to remove tumors, so opt for 440 kHz systems.
Pay attention to the choice of the necessary electrodes. For example, to quickly stop bleeding, it is important to increase the power and apply the appropriate electrode (ball), and a thin instrument (loop or string) is selected for excision.
Our managers will help you to choose a coagulator and a set of tools necessary for your needs.
Special modes and "chips" of BOWA electrocoagulators
Comfort and safety
The COMFORT system is a unique system developed by BOWA for registering the service life of reusable ECHF instruments. This solution was completely innovative and changed the way we look at safety and international standards for medical devices.
The COMFORT system allows you to register the number of applications, type, article, warranty period of the connected electrode, as well as automatically set the optimal settings for it.