Bipolar coagulation [Neurosurgery Wiki]

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====== Bipolar coagulation ======

A [[Bipolar]] [[sealer]] is a [[surgical instrument]] used to stop bleeding (achieve [[hemostasis]]) and seal [[tissue]] during operations. It's called "bipolar" because the electric current passes between two [[electrode]]s on the instrument, rather than through the patient's body to a grounding pad as in monopolar electrosurgery.

2. How it works:
- The device uses radiofrequency (RF) energy to heat and coagulate tissue.
- In many modern designs, like the one you mentioned earlier, saline is incorporated into the process (hence "Transcollation" technology).
- The combination of RF energy and saline allows for effective tissue sealing at lower temperatures than traditional electrosurgery.

3. Key features:
- Precision: Allows for targeted application of energy.
- Reduced thermal spread: Generally causes less collateral tissue damage compared to monopolar devices.
- Multifunctionality: Can often cut, coagulate, and seal tissues.

4. Common applications:
- Orthopedic surgery
- Cardiovascular surgery
- Liver resections
- Neurosurgery
- General surgery procedures

5. Advantages:
- May reduce blood loss during surgery
- Can potentially shorten operative time
- Might decrease the need for transfusions in some procedures
- Generally considered safer than monopolar electrosurgery in terms of unintended tissue damage

6. Considerations:
- Proper training is crucial for effective and safe use
- Different tissue types may require adjustments in technique or device settings
- While generally safe, there are still risks associated with any energy-based surgical tool

7. Ongoing development:
Companies continue to refine bipolar sealing technology, aiming for better efficacy, safety, and versatility across different surgical specialties.
----
[[Coagulation]] is an essential part of a surgical [[procedure]], especially in neurosurgery. Beginning in the early years of this century, various techniques have been used to control bleeding at the surgical site. Over the years, these techniques have led to the invention of the [[bipolar coagulation]] and its modifications. Prevention of charring and tissue adhesion have been the goals of bipolar coagulator manufacturers all over the world; new techniques and different metallurgical compositions for the forceps have been tried to achieve these results. 

The NS2000, with its microprocessor-based controlled coagulative sequence, can be a good system for reducing tissue adhesion and charring under desired limits of low output power ranges provided by the system. Comparable results can also be obtained with the Malis CMC III and Synergy Malis systems with irrigation channels. These systems have the additional advantages of providing higher power outputs at lower panel settings and a maximum power output greater than that of NS2000. For neurosurgeons who need the additional option of cutting, the Malis CMC III is the recommended system
((Dujovny M, Dujovny N, Gundamraj NR, Misra M. Bipolar coagulation in
neurosurgery. Surg Neurol. 1998 Mar;49(3):328-32. Review. PubMed PMID: 9508124.
)).

===== Bipolar forceps =====

see [[Bipolar forceps]].

===== Aquamantys =====
[[Aquamantys]]