ESD Brochure (PDF 881.5 KB) - ERBE Elektromedizin GmbH

DRY CUT
ERBEJET 2 waterjet surgical unit
This mode provides a cut with high coagulation effect and
ensures reliable hemostasis even when relatively large
blood vessels are involved. Reproducible effects with
low degree of smoke plume formation can be obtained
through voltage regulation.
In numerous disciplines, waterjet surgery has clear
advantages over alternative surgical procedures. Its
classic application is hepatic surgery. ERBE has gathered
many years of experience with this technology
– in other surgical disciplines as well.
Figure 1:
Marking of the lesion margin
Figure 3:
Layer-specific elevation of the mucosa
using the waterjet
FORCED COAG
Marking of the lesion is carried out using FORCED COAG.
During resection, bleeding can be coagulated using the
FORCED COAG mode and also any necessary post-coagulation
of the resection bed.
APC 2 Argon Plasma Coagulation
Apart from classic electrosurgical modes, another GI module,
the APC 2 Argon Plasma Coagulation unit, provides
safe methods for marking the lesion margins and can also be
used for hemostasis during and after the resection process.
The APC 2 unit enables non-contact coagulation; thus
there is no risk of tissue adhesion. Coagulation depth is limited,
controlled and homogenous. This almost completely
rules out any risk of perforation. The resection bed can be
coagulated with the APC completely and homogenously.
The waterjet pressure can be adjusted from effect 1 to effect
80 (this corresponds approximately to 1-80 bar). For
gastroenterology applications, an effect between 10 and
50 should be selected for the specific organ in question.
Please consult the table on page 10 for precise setting recommendations.
At low effect settings blood vessels and
nerves are spared, as are adjacent tissue structures and organs,
for the waterjet procedure works tissue-selectively
without producing any thermal effects.
These very features are what makes waterjet technology
ideally suited for mucosal elevation before endoscopic resection:
the selective waterjet penetrates the mucosa and
separates the tissue layers without use of needles while
respecting anatomical layers. The separation medium accumulates
in the submucosa located beneath the mucosa,
forming a fluid cushion between the mucosa and the muscularis.
The mucosa with the infiltrated lesion is elevated
and can be resected without the muscularis being injured.
For further information on waterjet surgery, argon plasma
coagulation and the endoscopic irrigation pump please go
to www.erbe-med.com or consult individual brochures.
Figure 2:
Surface coagulation with APC 2
04 HybridKnife