Koagulierendes Intermittierendes Schneiden

Abstract

In spite of the high and lasting efficiency of transurethral prostatectomy, intraoperative blood loss results in increased morbidity in this procedure. This led to the development of many alternative treatment modalities in the last years. To minimize the risk of bleeding, we improved the high-frequency technology in several steps. To achieve this, the output signals of commercially available high-frequency generators were modulated to the effect that each cut results in an efficient coagulation zone in the tissue at excellent cutting quality. Laboratory and in vitro studies using porcine kidneys as well as clinical trials showed good cutting characteristics accompanied by a significant reduction of bleeding. As a result, blood transfusions were less necessary, the transurethral catheter could be removed earlier in the postoperative period, and hospitalization time was significantly reduced. In conclusion, the improved high-frequency technology in form of the "coagulating intermittent cutting" results in a blood-sparing tissue resection with a consecutive reduction of morbidity.

Prostataresektion mit der Bandelektrode

“…Um vielmehr eine primäre Hämostase zu bewirken, gibt es verschiedene Lösungsansätze, wie z. B. die Modifikation der Resektionsschlinge (Bandelektrode,"thick loop") oder des Resektionsstroms (Vaporschnitt, intermittierende Koagulationsresektion) [3,4,8,10]. Die Bandelektrode nach Faul ist gegenüber einer konventionellen Drahtschlinge bei gleicher Dicke (0,3 mm) 4-mal breiter (1,2 mm) und hat dementsprechend bei gleicher Resektionsleistung eine länge-re Koagulationswirkung auf das umgebende Gewebe mit seinen Blutgefäßen.…”