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The Plasma surgery system excites specific ions (such as Na⁺ and Cl⁻ in physiological saline) through a high-frequency electric field to form a plasma layer, and utilizes the molecular bond breaking effect of the plasma to achieve precise cutting, ablation or hemostasis of tissues. Its core relies on the controllable energy transfer between the electrode and the tissue. Avoiding direct contact between the electrode and the metal instrument is a key operational taboo. The specific reasons and potential risks are as follows:
I. Core Reasons for Taboos
1. Short circuit of current disrupts the efficiency of energy transmission
The electrode of the Plasma surgery system is designed to operate in a "unipolar" or "bipolar" mode. The current needs to pass through the electrode → tissue → return electrode (or the other electrode) to form a closed circuit, thereby exciting the plasma at the electrode-tissue interface. If the electrode comes into direct contact with metal instruments (such as electrosurgical units, aspirator heads, titanium clamps, etc.), the metal, as a good conductor, will cause the current to bypass the target tissue and directly pass through the metal instruments to form a "bypass", resulting in the energy being unable to effectively act on the tissue, significantly reducing the cutting/ablation efficiency and prolonging the operation time.
2. Local overheating, causing damage to tissues or instruments
When current passes through metal contact points, due to the metal resistance being much lower than the impedance of the tissue (or plasma), a sharp increase in Joule heat (Q=I²Rt) will occur. The local temperature at the contact point may exceed 100℃, resulting in:
• Tissue thermal damage: Burns the surrounding normal tissues (such as nerves, blood vessels, and mucous membranes), increasing the risk of postoperative adhesion, infection, or functional damage;
• Instrument damage: The surface coating of the electrode (such as ceramic, Teflon) or metal instruments (such as stainless steel) may deform or corrode due to high temperatures, shortening the lifespan of the instruments and even causing intraoperative accidents such as electrode breakage or detachment.
3. Interfere with the stability of the plasma and affect the accuracy of the surgery
The generation of plasma depends on the specific electric field environment around the electrode (such as electric field intensity and ion concentration). The intervention of metal instruments can distort the local electric field distribution, leading to abnormal morphology of the plasma layer (such as expanded range and uneven density), and may cause problems such as uneven cutting edges and out-of-control ablation depth. Especially in fine surgeries (such as neurosurgery and laryngeal microsurgery), it may affect the functional preservation effect.
4. Risk of equipment failure
When high-frequency current passes through metal contact points, it may trigger arc discharge (electric sparks), causing oxidation of electrode interfaces and erosion of circuit boards. In severe cases, it can lead to errors reported by the main unit (such as "abnormal energy output" or "electrode failure"), and even damage core components, increasing medical costs.
Ii. Clinical Operation Suggestions
To avoid the above risks, the following norms must be strictly implemented:
• Separate the electrode from metal instruments: During operation, keep the distance between the electrode tip and other metal instruments (such as separation pliers, scissors) at least 2mm, and avoid direct contact.
• Use dedicated supporting equipment: Select non-metallic (such as ceramic, plastic) auxiliary equipment certified by the manufacturer (such as pullers, flushing tubes) to reduce metal interference;
• Real-time intraoperative observation: If blackening of the electrode surface, abnormal tissue carbonization or an alarm from the main unit is detected, the operation must be immediately stopped and the possibility of accidental contact checked.
• Regular maintenance of the equipment: When cleaning the electrode after the operation, avoid scratching. Check for any remaining metal debris and ensure the stable performance of the interface between the electrode and the main unit.
Summary
Avoiding direct contact between electrodes and metal instruments is a key guarantee for the safety and efficacy of plasma surgery. Its essence is to achieve precise tissue treatment and reduce the risk of complications by controlling the current path, reducing thermal damage and maintaining plasma stability. Medical staff need to have a profound understanding of its principle and strictly follow the norms during operation to maximize the surgical effect and ensure patient safety.
http://www.smartveingroups.net
SmartVein Group
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