Electrosurgery has been used for 85 years to aid surgeons in difficult surgeries such as the removal of tumors and hysterectomies and continues to provide a viable and effective device for controlling bleeding when excising highly vascularized tissues. Recently the introduction of J-Plasma, a helium gas plasma device, has added a tool with more surgical precision potential and a greater versatility to control bleeding and lessen the danger of collateral damage to surrounding tissue. Here is a brief comparison of the two modalities.
Electrosurgery
Electrosurgery is dependent on its basic functions of electrical charge transmission to cut, fulgurate and coagulate. It can be used with dissecting tips such as blades, needles or loops in a monopolar mode which requires the use of a return pad. It can also be used in a bipolar mode with special forceps or with proprietary high cost handpieces, in which case a ground return pad is not required. With electrosurgery one of the less desirable side effects is smoke and eschar. This is caused when the delivered electrical power causes the target tissue to desiccate, vaporize and eventually burn.
Monopolar mode: Is used to cut or dissect tissue, spot destroy tissue, or coagulate blood vessels. The electrical current used in this mode exits the body through a return, or grounding, pad.
Bipolar mode: Uses two electrodes in close proximity to each other, like forceps ends, allowing the electrical current to flow directly from one electrode to the other and avoiding the need for a return pad. This mode is most often used for coagulation, but is not effective for use over large areas or for dissecting tissue because the device must keep stopping and resetting itself multiple times while in use. In addition, each time the bipolar electrodes activate, the tips start to build up tissue eschar, eventually making them fouled.
J-Plasma
J-Plasma™ uses an ionized helium plasma stream flowing over a scalpel-like blade to create the required energy to dissect and denature tissue, or to coagulate blood flow in tissue. As opposed to the electrical energy being applied directly into the body during electrosurgery, the J-Plasma energy is concentrated within the plasma stream at and just beyond the tip of the stylus and does not require a return pad. This provides the surgeon greater control over the area on which the procedure is being performed.
The J-Plasma device is extremely versatile and can be used with the scalpel blade extended or retracted, with faster or slower gas flow and with higher or lower electrical power. When extended, the blade can be used for incisions and cutting during surgical procedures and can be used with or without J-Plasma gas flow. With the blade retracted, the device can still be used to form the J-Plasma stream for coagulation or blunt dissection.
The plasma stream of the J-Plasma device is formed by passing an inert gas, helium, over the blade, forming a plasma stream of approximately 15 mm or less depending on the power. This is ideal for soft tissue coagulation and cutting. The one button handpiece allows for easy activation and a grip to extend or retract the blade. The generator allows for more or less gas flow. More gas flow enhances the stream which has a cooling effect and is able to push blood and debris out of the way. It also allows for more or less electrical power which increases or decreases the temperature of the beam and enhancement of the cutting ability
The J-plasma unit has been found to be extremely versatile and economical to use.
