Introduction The PlasmaJet system is a unique novel technology that utilises argon gas that is electrically excited into a plasma state. This argon plasma energy is highly focused in a beam that disperses rapidly with distance therefore causing minimal deep thermal tissue injury, unlike all other electrical devices such as diathermy, argon plasma coagulator or harmonic scalpel.
Method The plasma stream that leaves the tip of the device releases kinetic, light and thermal energy that changes with distance and angulation to the tissue. These last two variables influence the dissection properties of the PlasmaJet. The closer the tip of device is to the tissue and the more acute the angulation, the greater is the kinetic and thermal energy stream, which produces to greater tissue separation and dissection.
Results Plasmajet subjectively allows for easier and more efficient division of routine but also fibrotic “hostile” adhesions which would otherwise have been extremely difficult even with scalpel dissection. PlasmaJet appears to cause less bleeding compared to conventional dissection techniques, but needs formal evaluation. Plasmajet can be used across the spectrum of coloproctology (see Table 1). Inadvertent tissue injury can occur, and was noted in 1/97 major complex colorectal procedures. The complication was an enterotomy identified intra-operatively and repaired with no post-operative sequelae. No post-operative mortality was seen. A small number of collections (≥3 cm fluid diameter) were noted but were not significantly higher than unit data.
Conclusion PlasmaJet represents a new surgical modality for efficient precise tissue dissection. It should be considered for any re-operative abdominal case where dense adhesions maybe encountered. It has minimal thermal penetration and is therefore very safe. It provides the surgeon with another valuable tool to aid difficult dissection of tenacious adhesions under very challenging conditions thereby improving patient outcomes.
Disclosure of interest None Declared.
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