ABSTRACT
Medical use of (non-)thermal plasmas is an emerging field in gynaecology. However, data on plasma energy dispersion remain limited. This systematic review presents an overview of plasma devices, fields of effective application, and impact of use factors and device settings on tissues in the female pelvis, including the uterus, ovaries, cervix, vagina, vulva, colon, omentum, mesenterium, and peritoneum. A search of the literature was performed on 4 January 2023 in the Medline Ovid, Embase, Cochrane, Web of Science, and Google Scholar databases. Devices were classified as plasma-assisted electrosurgery (ES) using electrothermal energy, neutral argon plasma (NAP) using kinetic particle energy, or cold atmospheric plasma (CAP) using non-thermal biochemical reactions. In total, 8958 articles were identified, of which 310 were scanned, and 14 were included due to containing quantitative data on depths or volumes of tissues reached. Plasma-assisted ES devices produce a thermal effects depth of <2.4 mm. In turn, NAP effects remained superficial, <1.0 mm. So far, the depth and uniformity of CAP effects are insufficiently understood. These data are crucial to achieve complete treatment, reduce recurrence, and limit damage to healthy tissues (e.g., prevent perforations or preserve parenchyma). Upcoming and potentially high-gain applications are discussed, and deficits in current evidence are identified.
ABSTRACT
Objective • To explore the safety and feasibility of using sutureless technique of argon beam coagulator in laparoscopic partial nephrectomy. Methods • A total of 10 patients receiving laparoscopic partial nephrectomy with argon beam coagulator in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from October 2016 to October 2017 were selected. The clinical efficacy and safety of the operation was retrospectively analyzed. Results • The average age of the 10 patients was 50.4 (24.0-73.0) years, the average size of the tumor was 2.1 (1.5-2.5) cm, and the average RENAL score was 5. All of the 10 patients underwent intraoperative renal artery occlusion. Intraoperative scissors were used to completely remove the tumor and remove the tumor bed after the resection. Then the argon beam coagulator was repeatedly used for hemostasis. After hemostasis was completed, the hemostatic gauze was covered on the surface of the tumor bed. The mean operation time was 95.0 (60.0-108.0) min, and the average thermal ischemia time of the renal artery occlusion was 7.8 (5.5-10.0) min. The average blood loss was 86 (50-150) mL during the operation. The average decrease of hemoglobin was 11.8 (3.0-22.0) g/L on the first day after operation. The mean indwelling catheterization time was 2.7 (1.5-3.5) d, the average time of hospitalization was 5.2 (4.0-7.0) d, the extraction time of drainage tube after operation was 2.6 (1.0-4.0) d, and the flow rate was 38.5 (10.0-80.0) mL. Conclusion • Argon knife spray coagulation has good efficacy and safety in patients with renal tumor renal resection, especially for some exophytic renal tumors, which has short operation time, less damage of hot ischemia, good postoperative effect, no increase in hospitalization time after surgery, reduced economic burden of the patients, being worthy of popularization and application.
ABSTRACT
Surgery and cryoablation have been the preferred method for treating drug resistant ventricular tachycardia (VT). Cryoablation, the therapeutic usefulness of which has been documented in many reported studies, is nevertheless not free from technical difficulaties. The advent of Bard<sup>®</sup> System 6000 Argon beam coagulator (ABC) as a new procedure alternative to cryoablation offered us a hope for solving problems with conventionally used techniques. Preliminary experiments with this device on dog myocardium permitted us to determine therapeutically adequate irradiation time and depth of cauterization and to locate an optimum area of myocardium to be coagulated. Based on these experiences, an attempt was made to use ABC as an adjunct to surgery in the surgical treatment of 4 patients with monofocal non-ischemic VT. In 1 of these 4 patients, VT disappeared postoperatively, making use of antiarrythmia drugs quite unnecessary, while in the remaining 3, a marked diminution of ventricular arrhythmia with a consequent reduction of drug dosage was achieved, use of the device thus being judged to be beneficial. These results led to the conclusion that ABC will provide a valuable adjunct to operation in selected cases of VT and, if the probe and other appliances are further refined, can reasonably be anticipated to be used as frequently as cryoablation.
