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In infrared contact coagulation the tissue
is coagulated not by means of an electric current but with
infrared radiation.
In treatment mechanical pressure and radiation energy are applied
simultaneously. The process of electrocoagulation used to date
is based on the heat of resistance (joule heat) produced when
high-frequency currents flow through body tissue. This requires
two electrodes – one inactive, with a large surface area
and usually applied to a region on the upper leg, and one small,
active, operating electrode. A basic shortcoming of this method
is the adhesion of the metal electrodes to the tissue, which
is particularly troublesome in the treatment of parenchymal
bleeding. A further drawback is that the extent of the necrosis
produced by the operation is difficult to control. In addition,
the morphologically determined electrical conductivity relationship
varies from region to region and from patient to patient.
The new infrared contact technique eliminates these disadvantages
and notably extends the range of methods for haemostasis in
a number of indications.
 The infrared contact coagulator consists of an infrared radiator, a rigid light
guide curved at the end at which the light emerges, and a tissue contact surface
or tip made from a Teflon® polymer that is transparent to infrared and does
not adhere to the tissue. The infrared radiation is focussed into the light guide.
A low-voltage tungsten-halogen lamp (15 V) produces the beam in a gold-coated
reflector
housing.
The red light and infrared leakage radiation is allowed to escape outside through
the red lamp casing, thus preventing the coagulator from overheating and making
it unnecessary to provide an expensive cooling system. The optimal amount of
energy to be transferred into the tissue can be pre-set exactly by means of a
timer and reproduced at all times.
The ergonomically designed applicator, fitted with a hand-operated switch and
supplied with low voltage by means of a flexible lead, enables the doctor to
work in a simple and convenient manner. |
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Coagulation time only 1 - 3 seconds |
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No tissue adhesion |
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Precisely adjustable depth of necrosis |
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Simpler and more effective than
injection treatment (proctology) |
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Also suitable for blood staunching |
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Various interchangeable light guides |
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Safe low voltage |
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No danger of explosion in the intestine
(proctology) |
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No effect on cardiac pacemakers |
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Can also be used during pregnancy |
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No inactive electrode |
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Can be sterilized by gas (60°C) or liquid |
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Because of its advantages and problem-free
operation, this new instrument for contact coagulation can
be used in a number
of applications. Thus, the equipment can be used in the operating
theatre as well as in the out-patient departments of clinical
and general practices.
The instrument has so far proven successful in the following applications: |
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The aim of any obliteration therapy is to throttle
off the vessels by scar-tissue shrinkage. This is achieved
in an ideal
manner by the infrared coagulator. In this application the
advantages mentioned in the description of the system, such
as the possibility of precise dosage of the thermal energy
and the lack of adhesion of the probe, are of decisive importance.
The pulse length determines the depth of the necrosis produced,
its circumference corresponding to the diameter of the lightguide
used.
However, the penetration is limited to a maximum of 3 mm, since if maintained
for too long the beam would cause the tissue to carbonize at the surface. It
is not possible to control the penetration to such an exact degree either with
electrocoagulation or with hot and cold probes, and similarly not by means of
sclerosing drug injections.
The hemorrhoids are first located with a proctoscope and the light guide of the
infrared coagulator is then inserted into the anoscope. The light guide, which
has a slight curve at its far end, is positioned just above the hemorrhoidal
nodes and the infrared lamp is
switched on by a switch on the instrument´s pistol grip.
A second coagulation, rotated 90° clock-wise, is then performed.
Since the tip of the probe is coated with a special polymer, it does not adhere
to the mucous membrane
after the irradiation and can be easily lifted off without tearing the tissue.
The irradiated site appears as a circumscribed area of greyish
mucous membrane. After one week it is still visible as a slightly in-drawn spot
with a reddish colour due to capillarization. After two weeks only a discrete
scarred area of in-drawn mucous membrane can be seen, which can no longer be
located after 3-4 weeks as normal mucosa grows over the site of the operation.
The infrared coagulator is suitable for
hemorrhoids of first and second degree and particularly for bleeding hemorrhoids.
As a rule, a general anaesthetic is unnecessary, although it is recommended in
sensitive patients in the outer anal region in front of the linea dentata. Comparisons
with patients treated by sclerosing drugs have shown that the therapeutic effect
could be achieved more rapidly by infrared coagulation and with less stress on
the organism. The system can also be used to good effect in the event of bleeding
following surgical interventions in the anal region, such as after the removal
of papillary hypertrophies in the anal canal or rectal polyps after mucosal biopsies. |
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| Many women go to the doctor with vaginal discharge. Benign
portio lesions are the most common cause of this phenomenon.
In these cases the infrared coagulator provides a genuine alternative
to cryosurgery and to thermo-coagulation with electrodes. The
wound secretion and the general stress on the patient are minimal.
The therapeutic concept of coagulation of benign portio and
cervix
lesions with infrared radiation
broadens the possibilities of out-patient treatment in
gynaecological practice. |
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Diffuse bleeding from wounds of relatively extensive
area is not uncommon in ENT medicine. It is above all in fragile
tissue that haemostasis – always aimed at even in the
case of small vessels – often cannot be achieved by ligatures.
The use of haemostasis has
proved its worth above all for blood staunching after tonsillectomy.
It has been found that the extent of the tissue destruction
can be essentially better controlled and reproduced by means
of the new coagulator. In this way haemostasis is possible
with minimum accompanying necrosis. The possibility of using
the technique in wet wound milieus permits surface treatment
of the wound bed without any danger to the neighbouring structures.
Further areas of application are blood staunching after adenotomy, bleeding in
inoperable malignomas containing many vessels, and also endoscopic blood staunching
in the nose and the larynx.
Palliative destruction of tumours appears to be another possible application
of the contact coagulator, this being currently at the stage of clinical tests. |
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The treatment of extensive haemangiomas on the body surface
and of naevus flammeus can pose problems. Conservative modes
of treatment, such as X-ray therapy, sclerosing injections,
and therapy with corticosteroids are always encumbered with
considerable secondary damage and their outcome is uncertain.
Treatment with the coagulator is performed over several sessions, sometimes with
a local anaesthetic and sometimes under short-term anaestesia.
Further indications are the bleaching out of haemangiomas and the treatment of
warts by surface coagulation, as well as removal of tattoos. |
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 Bleeding parenchymal areas still represent
a surgical problem. The inadequacy of the conventional methods
is likewise reflected in the rates of mortality and complications
of liver rupture as well as in the frequent necessity of
removing the spleen just because its capsule has been very
slightly damaged.
The infrared contact coagulator sets new therapeutic standards in such cases.
Pressure of the applicator against the tissue simultaneously displaces the blood
from the surface, compresses the bleeding vessels, and – depending on the
duration of the IR-Light-pulse – a variable amount of energy is emitted
into the tissue where it is absorbed, thus causing the coagulation. This process
is continued in steps, and if necessary repeated until a dry coagulation surface
has been formed.
In the clinical applications of the coagulator to the liver, spleen, and kidneys
tried out so far it was possible to achieve adequate heamostasis by superficial
coagulation of the tissue surfaces. |
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Rapid blood staunching following extractions or other surgical
interventions in the oral cavity in patients with disturbed
or delayed blood coagulation is a further sphere in which the
infrared contact coagulator can be used. For example, it can
be used in anti-coagulation therapy, in low-grade haemophilia,
or in coagulation disorders after the taking of analgesics.
After removal of the gelatin sponge, the light guide is placed
in the cavity left by the tooth and the light pulse is triggered.
After lifting off the Teflon® tip, the bleeding is staunched
and the cavity is sealed.
In this way, the infrared coagulator is also suitable for extractions in dental
practice on a routine basis since the blood is staunched
within a few seconds.
The light guide is sterilized by immersion in an upright vessel containing a
sterilizing fluid. |
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 For use in all kinds of medical domains we
supply a range of light guides of various lengths and diameters
as attachments
to the basic coagulator apparatus. The circumference of the
necrosis produced is determined by the diameter of the light
guide used. The light exit surface of the guide is protected
by a replaceable Teflon® tip. This tip constitutes the
contact surface and prevents the guide from sticking to the
tissue. |
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| Nearly undestroyable. Better surface cooling than with a
Teflon® tip, resulting in less carbonisation of the tissue
and slightly deeper necrosis. Recommended for removing tattoos.
Preferably used in surgery. |
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| Quartz glass light
guides with diameters 2mm, 6mm and 10mm. Handapplicator,
spare lamp with goldreflector. |
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ø 2mm, ø 6mm
and
ø 10mm Teflon® or sapphire tips |
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| Power unit: |
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| Mains voltage |
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100/120/230 VAC |
| Frequency |
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50... 60Hz |
| Power consumption |
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240 VA |
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| Handapplicator: |
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| Lamp voltage |
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15 V |
| Power |
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150W |
| "int" |
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6 sec. / 100 sec. |
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| Lightguide: |
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available in ø 2mm, ø 6mm and ø 10mm.
Length: from 70 mm to 420 mm |
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| Weight: |
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approx. 2.8kg |
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| Protective Class: |
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I, according to VDE 0750 (IEC 601/1) |
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This equipment may not be operated in areas
that are not explosion safe.
Specifications can change without notice.
Downloads
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