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How does a grounding pad avoid injury with monopolar
energy? - Answers-Grounding pads help avoid
capacitative coupling. This happens when two conductors
are separated by an insulator and the passive electrode
stores energy that can be released with tissue injury. The
grounding pad inhibits the passive electrode from storing
energy.
Benefits of bipolar energy. - Answers-- Lower risk of
inadvertent injury.
- Produces less thermal spread and necrosis.
- No grounding pad necessary.
- Works in a "wet" operative field.
Risks of bipolar energy. - Answers-May cut patent blood
vessels before adequate sealing. Device will not work if
there is metal between the jaws.
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Risk of ultrasonic dissection (harmonic). - Answers-The
active blade can inadvertently injure something due to
high frequency (50mHz).
Does aspirin need to be discontinued day of surgery. -
Answers-No
How to best enter a patient with bowel obstruction. -
Answers-Direct visualization.
Cut vs Coag - Answers-Cut: Heats tissue quickly to
convert cell water to steam, lysing the cell.
Coag - Heat more widely dispersed, less cutting.
Benefits of "Cut mode" - Answers-- Low voltage
- High frequency
- Continuous waveform
- Heats tissue quickly. Cell water converts to steam and
causes the cell to lyse/explode.
Benefits of "Coagulation mode" - Answers-- High voltage
- Low frequency
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- Intermittent waveform
- Rapid tissue heating, shallow depth of necrosis.
- Non-contact. Relies on sparking to tissue.
What is direct coupling? - Answers-When a monopolar
instrument is in direct contact with another metal
instrument and energy is transferred.
What are other dangers of energy use besides direct and
capacitative coupling? - Answers-- Current diversion
- Narrow return circuit.
Bipolar seals vessels up to _____ mm in diameter. -
Answers-7mm
Ultrasonic coagulation shears seal vessels up to
_____mm in diameter. - Answers-5mm
Benefits of Ultrasonic Coagulation shears. - Answers--
Combo compression and friction.
- One active blade.
- Monopolar capabilities with the active blade.