Use of argon plasma coagulation in endourology: in vitro experiments.

摘要

OBJECTIVES: To investigate different parameters influencing argon plasma coagulation (APC) in a fluid medium with regard to endourologic procedures. APC is a novel therapeutic modality of noncontact electrocoagulation that applies high-frequency current by way of ionized argon gas. Recent modifications for endoscopic application of APC have helped to establish new indication in various surgical fields. METHODS: Standardized experiments using an endoscopic APC device were performed on fresh bovine skeletal muscle in different fluid media. The effects of the power setting, gas flow rates, and treatment duration on the coagulation zones and tissue ablation were evaluated. RESULTS: The coagulation zones were remarkably uniform. The depths of coagulation increased significantly with augmented power settings and APC duration but were not dependent on gas flow rates. Likewise, tissue removal increased with greater power and longer application times but was not affected by flow rates. Tissue ablation in general was moderate. Different fluid media generated varying performances. CONCLUSIONS: Using a laboratory model, we demonstrated that APC performed in a fluid medium is feasible. The power setting, treatment duration, and different fluid media were interdependent factors affecting the performance of APC in a fluid milieu. However, before application of APC in endourologic procedures in humans, additional studies concerning safety issues are mandatory.