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1. djustable blades f Plasma Wand EIC7071 01 Standard cuffed microlaryngeal tubes are adequate for protection of the lower airways from any excess saline This can be aided by gentle packing above the balloon with wet cottonoids Chance contact of the Coblation Wand with the tube will not cause damage to the tube NOTE Recent studies about airway fires suggest that using Cobla tion technology in place of traditional electrosurgical or laser devices during oropharyngeal surgery significantly reduces risk of igniting an airway fire due to the low heat generated and the lack of spark or ignition medium under normal operating circumstances 123 Special endotracheal tubes used with lasers are not necessary Venturi ventilation has also been used successfully when Coblation is used A head down Trendelenberg position should be utilized to ensure any excess saline flows into the pharynx and not the trachea Coblator I TECHNIQUE GUIDE Procedure To ablate tissue position Wand tip in close proximity to target tissue aT Adud be taken in monitoring the targeted tissue during Ablation to ensure consistent and controlled tissue removal is maintained Care should also be taken to ensure surrounding tissue is properly monitored Due to the smaller anatomies of certain patients carefully monitor the surrounding tissues to ensure tissue Ablation is localized to the targeted tissue Press the ablation function yellow peda2. l of the Foot Control to activate the Wand Make brief contact 1 2 seconds with target tissue through the use of a dabbing motion Continue Wand activation briefly after removing tip from target tissue to allow digestion of any tissue on the electrode surface before deactivating the Wand by taking your foot off the Foot Control Before After Thermal Effegt Aninaa Medel keep ktive electrode directly facing target tissue User should always pay close attention to the depth orientation and 600 coverage of the Plasma Wand and to its proximity to surrounding un targeted tissue Ensure non targeted tissue does not contact exposed _ 900 metal of active or return electrodes is 400 NDOTriot bend the Wand shaft or rub the Wand tip against target 3 tissue during ablation as this could result in clogging of the suction 300 line Do not use the Wand suction line as a standard surgical suction E device to clear debris from the surgical field as this could result in S 200 clogging of the suction line amp 100 To coagulate position Wand tip directly over the source of bleeding and depress the Coagulation function on the Foot 0 Control Default Maximum Default Coblate Coblate Coag Device Settings Histology Animal Model 1 Smith LP Roy S Operating room fires in otolaryngology risk factors and Refersention Am J Otolaryngol Article in press Epub 2010 Apr 14 2 Roy S Smith LP Device related risk of fire in orophar
3. re se TECHNIQUE GUIDE ArthroCare i i Coblation for Laryngeal Lesions amp Tracheal Procedures Coblation The PROcis MLW Plasma Wand provides small lesion Pin point ablation and coagulation capabilities Coblator II Surgery System Setup Set up the Coblator Il System and the PROcise MLW Plasma Wand according to the Controller User s Manual and Wand Instructions for Use IFU Active electrode Suction port NOTE This guide is not intended to replace the Coblator II User s Manual or Wand IFU Thoroughly review the User s Manual and Wand IFU before installing or operating this system Return electrode Saline delivery port Default settings Coblate 7 Coag 3 Adjust as needed and per surgeon preference Insulated shaft outer diameter at tip 2 8mm NOTE Maintain the lowest power setting necessary to achieve the desired end effect Connect the Wand s suction tubing to an OR suction source separate from any other suction instrumentation Suction should be set to a lower setting approximately 250 psi Connect the Wand s saline tubing to bag of normal saline and adjust saline flow to a minimum intermittent drip Patient Other Preparation To ensure optimal visualization throughout the procedure the Wand can be used with standard laryngoscopes and microscopes Use the largest laryngoscope that can be accommodated Particularly useful are those with PROcise MLW proximally and distally a
4. yngeal surgery a mechanical model Am J Otolaryngol 2010 Sept 31 5 356 359 This article references preclinical non human data As such results may not necessarily be the same in human procedures 3 Matt BH Cottee LA Reducing risk of fire in the operating room using Coblation technology Otolaryngol Head Neck Surg 2010 Sept 143 3 454 5 4 Data based on tongue tissue in an animal model results may not be the same in humans Data on file report 35764 01 5 Data based on vocal fold study in an animal model results may not be the Default Coblate Setting Default Coblate Setting same in humans Data on file report 35766 01 Day 3 Day 21 Calle 160 N 8B 28 Piso 2 PBX 57 1 4673657 gt gt USA 1 713 429 4367 f M vil 57 320 2110729 MNEDICAaAL fernando rincon eXelmedical com Renovaci n sin l mites fernando rincon osteocel com co Bogota Colombia www exXelmedical com
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