OPERATORS
MANUAL
Specialist
~lectrosur~ical
MDT Diagnostic Company
-
Unit
-
Technology for Life
500007
Rev.
C
OPERATORS MANUAL
Rev. 2 (12/15/81)
Rev.
C
(
9/14/88) Retyped and MDT
500807
Logo
and Address Added
CAUTION
DESCRIPTION OF SYMBOLS
The following symbols with related notes appear
"Warning" notes alert the user to the possibility of personal injury.
"Caution" notes alert the user to the possibility of damage to the equipment.
"Notes" alert the user to pertinent facts and conditions.
Users must read and understand the contents of this manual before
using the equipment.
&
NOTES IN MANUAL
in
this manual.
The
BOVlE
only for use by qualified physicians and surgeons. Misuse or misapplication of this device may result in serious physical harm to the patient
andlor user. It is imperative that this manual be read and understoodprior to use
of the equipment.
Specialist is a sophisticated medical device intended
RETAIN THIS MANUAL FOR FUTURE REFERENCE!
-MDT,
i
i
BOVlE
and CHUCK-IT are registered trademarks.
TABLE
OF
CONTENTS
...
PAGE
....
4
1
4
3
4
4
5
6
6
9
9
9
10
19
11
11
12
13
SECTION
"
.
1 . INTRODUCTION
Preface to Electrosurgery
Introduction to the Specialist 1
Unpacking
Power Requirements
Location in Office 1
2 . OPERATION
Operating Controls
Description
Circuitsentry
Initial Check-Out Procedure
Features
Accessories
Checking Cords. Connections
Electrosurgical Currents 9
Electrosection (Cutting Current)
Electrocoagulation
Desiccation and Fulguration
3
.
SAFETY AND PRECAUTIONS
General Precautions
Anesthetic
Prevention of Burns
Patient with Cardiac Pacemaker 12
Grounding the Unit 12
Preventing High-Frequency Skin Burns
Review of Action Steps for Safety
............................................................
...........................................................
.......................................................
.......................................................
..........................................................
........................................................
..................................................................
....................................................
.................................................
........................................................
................................
...................
...................
..
........................
...
..............
....
....
..
....
.....
..................
.....................................................
........................
..
...
...‘..........
..
..........................................................
...........................
....................
..
.........................................................
.........................................................
..............................................
..........................................................
................................
.............................................
4
.
SUGGESTED POWER SETTINGS
Power Required
Suggested Power Settings
Output Power vs . Dial Settings
Electrical Specifications 19
Mechanical Specifications 19
Limitations of Equipment 19
5 . EXPERIMENTS IN ELECTROSURGERY
Preliminary Experimental Work 21
Experiment with Electrosection (Cutting) 22
Experiments with Coagulation 23
Experiments with Fulguration and Desiccation
Summary
6
.
ACCESSORIES & OPTIONS
........................................................
......................
.........
.. ..
................
...............................................
.....................................................
...................................................
....................................................
...............................................
.....................................
................................................
................................
...................................................................
..............................................
15
16
18
26
26
27
iii
BOVlE SPECIALIST ELECTROSURGICAL UNIT
AND Sf ANDARD ACCESSORlES
MONO-POLAR 81-POLAR HAND/ FOOT DISPERSIVE
OUTPUT
P'
f/
CHUCK HANULE
1
r
\
FORCEPS
MANUALS-OPERATOR'S
7
SERVICE
BLADE
ELECTRODE
\
h
POINT
NEEDLE
LOOP
HAND
ADAPTER
CONTROL
~nn~
.
--.
CONTROL
DISPERSIVE
ELECTRODE
BOVIE SPECIALIST ELECTROSURGICAL UNIT
INTRODUCTION
1.
Introduction
PREFACE TO ELECTROSURGERY
Electrosurgery has become an important modality in modern medicine. The BOVIE Specialist is a
versatile and safe unit providing a unique coagulation
/hemostasis waveshape with superior clinical performance. The availability of accessories and a wide
selection of electrodes will provide many surgeons
with an instrument that can be utilized effectively in
specialized minor surgery.
The Specialist is designed with a graphic around
the Coagulating Power Control Knob which depicts
the power settings to be used for various types of
electrodes. The graphic is based on bi-terminal
techniques utilizing a dispersive electrode. It is
an exact setting for any procedure. However, it can
be used as an aid for safe approximate settings,
thereby reducing the chance of electrode damage
or excessive tissue destruction.
Electrosurgical units provide currents essential
to office practice in proctology, dermatology, oral
surgery, gynecology and are also valuable in major
surgery. The final choice of currents is based on the
surgeon's knowledge and experience in obtaining
an incision current (Cut), a destructive current
(Coagulation/Fulguration)
rent (Hemostasis).
The nature of this equipment as a low power
electrosurgical unit makes it unadaptable
(Transurethral Resection of the Prostate) and some
other major surgical procedures.
or a combination cur-
not
to TURP
INTRODUCTION TO THE SPECIALIST
The BOVIE Specialist, like all electrically operated equipment, must be properly installed to avoid
any chance of electrical shock. It is a source of high
frequency energy, and it must be used properly to
prevent excessive tissue destruction. The information contained in the following sections is intended
to provide a basic understanding of the factors
involved in the use and service of this equipment.
For user convenience, the manual is physically
divided into an Operator's Section and a Service
Section. These may be separated and placed in an
operatory and a service area at the user's option.
Both sections, Operator's and Service, are intended to assist the user in proper BOVIE operation.
A Parts List is included in the Service Section.
The Operator's Section includes a review of
"Experiments in Electrosurgery." However, the
not
review is
only as a common point of reference for clinical
applications.
intended as a clinical training manual,
UNPACKING
Carefully remove the Specialist generator and
other partsfrom theshipping container. Ensure that
no parts are discarded with the packing material.
Inspect the components for shipping damage.
Report any such damage immediately.
Use the following packing list to confirm receipt
of all parts:
PACKING LIST
1.
Specialist Generator Assembly
2.
Active Chuck Handle
3.
Box of Five Electrodes: Ball, Point, Loop, Blade
and Needle
4.
Foot Control
5. Dispersive Cable
6.
Dispersive Electrode and Tube of Liquid Gel
7.
Hand Control Adapter and Sample Hand
Control
8.
Operator's Manual
9.
Warranty Card
POWER
50/60 Hertz power source furnishing a maximum of
130 volts. The volt-ampere requirements are below
conventional wiring ratings.
REQUIREMENTS
The Specialist is designed to operate from a
LOCATION IN THE OFFICE
The specialist generator can be placed
desk, wall or cart. The outlet must be of the
wire grounding type.
cut off or by-passed with a non-grounded adapter
("Cheater plug") to avoid use of
If so used, the Specialist would not be properly
grounded and will void the warranty. If there is any
doubt about the ground connection, consult your
electrical contractor and make any recommended
outlet changes.
Use the handle on the back of the generator to
carry the Specialist.
The grounded leg must not be
a
three-wire outlet.
on
three-
a
NOTES
BOVlE SPECIALIST ELECTROSURGICAL UNIT
OPERATION
OPERATING CONTROLS
CUTTING POWER (yellow)
To vary the amount of
CUTTING
TO
forms. Pure Cut has
minimal Hemostasis. useful in desiccation. power for Coagulation.
Cut with Hemostasis has
a moderate amount.
TYPE
select cutting wave AMPLITUDE CONTROL (blue)
(yellow) POwerfor Cutting.
Makes cut with hemostasis
I
COAGULATING POWER
To vary the amount of
PULSE CONTROL
Gives excellent fulguration.
2.
Operation
ELECTRODE SYMBOLS
(Coagulating)
Symbols are approximations for Bi-terminal
Procedures.
POWER (white) 81-POLAR FORCEPS OUTPUT
ON-OFF Switch tor A white and a Receptacle for
main power to the
unit. Indicator
llght when switch
ON. MONO-POLAR OUTPUT
will
is
White receptacle for
Chuck Handles or
Adapter. Control Accessories.
tjlack receptacle for
Bi-polar Forceps plugs. Cable.
(Foot actuated only).
CONTROLS, OUTLETS
AND
\
HANDIFOOT CONTROL
Receptacle tor Foot
Control or Hand
MONITORS
DISPERSIVE ELECTRODE
Dispersive Electrode
RF
OUTPUT (amber)
Monitor
Unit
is
Outout Terminals.
Monitor will light when
dispersive electrode
circuit is NOT complete.
Output power cannot be
activated when
light
will light when
is
activated. Power
available at the
is
ON.
BOVlE SPECIALIST ELECTROSURGICAL UNIT
2.
Operation
DESCRIPTION
Electrosurgical units are alternating current
generators of high frequency. Passage of these currents through living tissue
ulation. The BOVlE Specialist operates at a fundamental frequency of
that pass through tissue with no stimulating effect
except for the normal heating produced by all
trosurgical currents.
Controls - Provide the operator with a selection of
two cutting modes and adjustment of output levels
for Cutting and Coagulating.
Receptacles - On the Front Panel supply output
power to electrodes and receives signals from
Footswitch pedals or hand actuated controls.
Coagulating - Will
attempt is made to energize both simultaneously.
Coagulating being the safest or least destructive
mode of operation.
Monitors - Lights on the front panel indicate nor-
mal or faulty operation of the equipment.
The
amber
monitor indicates actuation of either
the Cutting or Coagulating mode.
will not cause nervestim-
1.75
megahertz, and at ranges
always
override Cutting if an
elec-
The
red
monitor indicates an incomplete disper-
sive electrode circuit and the disabling of the out-
put power. This is the normal operation of the
Circuit Sentry Monitor.
Audible Signal
-The specialist contains a two tone
audible signal Po indicate when the output power is
activated and in which mode the unit is operating.
A
higher pitched tone indicates the Cutting mode and
a lower pitched tone indicates the Coagulating
mode. Volume of the audible signal is adjusted by
turning the level control, accessible through the
bottom of the unit.
CIRCUIT SENTRY
A
D.C. monitor signal flows from the specialist
through one wire of the dispersive electrode cable
to the dispersive electrode. The signal returns
through the other cable wire, and the Specialist is
ready to operate.
light will be off.
If the circuit path is interrupted by more than a
200
Ohm resistance, the
on, and the unit will automatically shut off.
The red Circuit Sentry monitor
RED
monitor light will go
--__F___t-
DISPERSIVE ELECTRODE RECEPTACLE
CIRCUIT SENTRY
DISPERSIVE ELECTRODE
BOVlE SPECIALIST ELECTROSURGICAL UNIT
INITIAL CHECK-OUT PROCEDURE
Turn the three control knobs to the full counter-
1.
clockwise position.
Insert the AC Power Plug into a three-wire
2.
115
grounded type
3.
Without
white power
will
light will
accessory connection.
Insert the Dispersive Electrode Cable into the
4.
DISPERSIVE ELECTRODE receptacle. use of the
5.
Attach the blue plastic cable connector to the
Dispersive Electrode. Use a straight pull on the
grip surface of the connector.
This connection will complete the circuit and
thered CIRCUIT SENTRY monitor will goOFF.
The BOVlE Specialist is now ready to actuate.
Connect the footswitch adapter into the HAND/
6.
FOOT CONTROL receptacle. Rotate plug until
the keyways mesh, then turn knurled portion
clockwise to secure pl
attaching any accessories, depress the
ON/OFF button to ON. The button
light and thered CIRCUIT SENTRY monitor
go
volt/60
ON.
-rhe unit is
Hz.
service outlet.
now
ready
for
7.
8.
9.
procedures are attempted. Technique experiments
are
tion..
skilled surgeon to develop an operational feel for
the
surgical equipment.
iar with the "General Safety and
tion of this manual. These brief statements will
to mind many of the concerns and potential hazards
inherent to electrosurgery.
2.
Operation
Actuate the footswitch in the CUT mode. The
Amber RF OUTPUT monitor will light and the
high pitch audible signal will sound.
Actuate the footswitch in the COAG mode. The
amber RF OUTPUT monitor will light and the
low pitch audible signal will sound.
Selecttheapplicableactiveaccessor~andelec-
trode for the required surgical procedure.
The surgeon should become familiar with the
BOVlE Specialist before any actual
reviewed
of
unique>haracteristicsof thi~'~articular electro-
In addition, the surgeon should become
this
in
the
manual
will
Experiments
prove
helpful
Precaut~ons" sec-
Set-
to
fam~l-
br~ng
ACTIVE ELECTRODE
ACTIVE CHUCK
HANDLE AND CORD
DISPERSIVE
ELECTRODE CABLE
DISPERSIVE ELECTRODE
GENERATOR AND ACCESSORIES
BOVlE SPECIALIST ELECTROSURGICAL UNIT
2.
Operation
FEATURES ACCESSORIES
The safety and versatility of the BOVlE Special-
ist include the following features:
e
Circuit Sentry monitoring (Dispersive Electrode).
e
Coagulation overrise when inadvertent actuation
of Cut and Coagulate is simultaneous.
e
Coagulation Electrode Symbols.
a
Output only to the selected active electrode.
e
Distinctive separate audio tones.
Bipolar outlet. following illustration.
Active Electrode Outputs
Allactive accessories leads should be
foot
ing efficiency.
Active electrodes can be energized by either a
foot control or a hand control. This is shown in the
in
length to obtain maximum operat-
10
TYPE
OF
ACTUATION
,P-
CONTROL MONOPOLAR FORCEPS
HAND
CONTROL
MONOPOLAR
BIPOLAR BIPOLAR FORCEPS
MONOPOLAR CHUCK HANDLE WITH
ACTIVE ELECTRODES
Reusable Chuck Handle
This type of active accessory is the most versa-
tile of all shapes and configurations for surgeon
preference. The cord plugs directly into the MONOPOLAR OUTPUT receptacle.
Insert the electrode into the open end of the
chuck handle. The electrode may not seat com-
C)
INSERT AND SEAT
ACCESSORY CHUCK HANDLE WITH
/-
SINGLE ELECTRODE
SINGLE ELECTRODE
pletely until the chuck jaws inside the chuck handle
are fully opened. To open, hold the barrel of the
chuck handle while turning the cable end
counterclockwise. Seat the electrode fully and close chuck
jaws by turning the end of the chuck handle clock-
wise.
CLOSE
ELECTRODE
HANDLE
INSERTING ELECTRODE INTO HANDLE
Optional Disposable Chuck Handle (Chuck-it)@
A disposable chuck handle is used with the
addition of a
directly into the chuck handle; there is no locking
.Some chuck handles are supplied with the
twist.
electrode built into the chuck handle.
BOVlE adapter. The electrodes slip
DISPOSABLE CHUCK HANDLE ELECTRODE
BOVlE SPECIALIST ELECTROSURGICAL UNIT
2.
Operation
1.
Plug the insert terminal into the adapter.. It will
be secured by a spring latch.
Plug the adapter into the white MONO-POLAR
2.
OUTPUT receptacle.
I
TO WHITE MONOPOLAR
OUTPUT RECEPTACLE
___)
1
DISPOSABLE CHUCK HANDLE
Optional Hand Control
The BOVIE Specialist can accommodate a hand
control with the use of a plug adapter. Hand controls
provide fingertip control of the cutting or coagulating currents. They are used in place of the conven-
tional footswitch control.
HAND CONTROL
3-PIN CONNECTOR
ADAPTER
The hand adapter plugs into the same
cle as the foot control. When the hand control adapter is connected, the foot control output circuits are
disconnected.
TO SPECIALIST
HAND/FOOT CONTROL RECEPTACLE
recepta-
-
HAND CONTROL
HAND CONTROL ADAPTER
.
BOVIE SPECIALIST ELECTROSURGICAL
2.
Operation
UNIT
Footswitch Control
Power output from the white monopolar receptacle can be obtained only with a footswitch accessory. This outlet allows any monopolar accessory to
produce cut or coagulation currents.
Po connect the footswitch plug, slowly turn the
1.
flexible connector portion of the plug until the
pins mesh with the receptacle holes.
Turn the knurled portion of the plug clockwise
2.
to lock the plug into the receptacle.
Forceps
Forceps are used to grip tissue between the
blades or tips of the electrode. Coagulation current
should be applied after the forceps grasp the tissue.
Effectiveness of forceps coagulation depends on
the
size
Of
the
blades
tissue gripped. Larger blades require more power,
also, as the volume of the tissue being gripped
increases, the power requirement increases.
There are two distinct modes of forceps operation; monopolar and
ical effects which should be observed by the surgeon. Monopolar forceps coagulate at the gripped
tissue first and then deeper into the tissue as the
application of current continues. Bipolar forceps
coagulate across the gripped tissue.
Monopolar Forceps
niques require footswitch activation, power being
available at the white monopolar receptacle.
and
the
surface
dipolar. Each have distinct clin-
-
Monopolar forceps tech-
area
Of
the
Coagu-
lating currents with this adapter require bi-terminal
techniques since both bladis of thi monopolar forceps are active. Coagulating currents must return to
the
dispersive
sis. A coagulating power setting can be estimated
by comparing electrode pictorial size on the gra-
phics
to
m~n~~~larf~r~ep~ blade size being used.
smaller area of contact would require less Power.
Bipolar Forceps
quire coagulation currents to flow from one blade of
the forceps through a small area of tissue to the
other forceps blade. Because of this small area of
contact, power must be radically reduced. The
coagulation graphics as presented on the
Specialist do
because technique depends on various forceps
blade sizes, tissue grip and areas of contact. Lower
settings than
geon acquires a "feel" for the Specialist and its unique capabilities. Surgical procedures using bipolar
coagulation can be referenced only by skill and
experience similar to that obtained for cutting
currents.
Depending on the accessory used, bipolar forceps may be actuated by either footswitch or hand
control. The dispersive electrode is always connected and need no actuation. The black outlet for
the indifferent electrode acts as a current return
path in place of the dispersive electrode.
Both cutting and coagulation currents are
available at these outlets, and determination of
coagulating power settings are at the discretion of
the surgeon.
electrode,
for
effective tissue
necro-
A
-
Bipolar forceps techniques re-
BOVIE
not
represent suggested settings,
normal should be used until the sur-
MONOPOLAR
ACTIVE
/cl
FORCEPS COAGULATION
ACTIVE
BIPOLAR
///
,
FLOW
BOVlE SPECIALIST ELECTROSURGICAL UNIT
2.
Operation
Dispersive Electrodes
The reusable stainless steel dispersive electrode must be clean to ensure a safe and good contact. Always clean after each use. To clean, discon-
nect the electrode cord from the electrode and wash
in hot water with mild detergent, rinse and dry thor-
oughly with
a
towel.
Disposable dispersive electrode should be
highlyflexible, have medical grade adhesive, and be
applied with a liberal amount of electrosurgical
conductive medium (BOVIE Gel Conductor). The
dispersive electrode should be large enough for the
full output of the generator. The recommended min-
imum area for the Specialist is 50cm2
(7.8
in.2). Follow all manufacturer's instructions and recommendations when using disposable dispersive electrodes.
CHECKING CORDS, CONNECTIONS
It is important that all cords and plugs be frequently checked for breaks in insulation or electrical contact. When plugs are pulled out of receptacles,
grasp
cords may pull the connections loose.
the
plug,
not
the
cord.
Jerking on the
The Pure Cut current is almost devoid of any dehydrating effect.
Its usefulness therefore, is predominantly in nonvascular areas or where fast cutting is
the only requirement.
It has advantages in confined areas where the
utilization of the cold scalpel becomes impractical.
Application of the cutting current of the BOVlE
Specialist is
always
bi-terminal (dispersive electrode) and requires more understanding and skill
than the dehydrating currents.
Cut with Hemostasis
Clinical requirements for cutting with a dehydrating effect requires a blend of cutting and coagulating currents with the result being a cutting capable of sealing small vessels during electrosection.
The BOVlE Specialist provides this hemostasis by
the surgeon's selection of cutting type. This
stasis cutting current could be a more desirable
method on some electrosection since a moderate
amount of dehydration will occur.
This mode can also be used very effectively in
desiccation coagulation where a precise fine spark
is desired.
hemo-
Age and repeated sterilizations can cause
cracks in insulation which might result in
burns to patient or surgeon.
Disposable Chuck-It active cables and dispersive electrode cables are completely tested for continuity at the factory. This eliminates the need for
any test before use.
ELECTROSURGICAL CURRENTS1
The BOVlE Specialist, as indicated earlier, is
designed to provide high-frequency energy for the
purpose of cutting, coagulating, desiccation or
fulguration.
ELECTROSECTION (Cutting Current)
Pure Cut
The waveform of the Pure Cut current is essentially sinusoidal. Its effect is to heat tissue cells so
quickly that they volatilize or explode in the path of
the electrode. Tissue parting is similar to a sharp
cutting blade. The heat generated by the electrode
arcing also causes a slight zone of dehydration at
the severed edges. This will seal off minute vessels.
ELECTROCOAGULATION
Coagulation is always bi-terminal (dispersive or
indifferent electrode is used) and tends to produce
more necrosis of tissue than desiccation. The destruction effects are not as quickly limited by a zone
of dehydration. Therefore, this current is more
effective on large or deep growths. Active electrodes such as needles, pointed rods, or small balls
are always used in contact with the tissue; either
firmly pressed against the tissue to be coagulated,
or inserted into it. The tissue area of contact being
constant, the amount of coagulation around the
electrode is dependent on the amount of current
and length of time it is applied.
Continued
'Adapted from Principals of Minor Electrosurgery, John
Jr.,
M.D.,
Liebel-Flarsheim Company,
1957.
Pages
8-1
. .
1
F.
Otto,
BOVlE SPECIALIST ELECTROSURGICAL UNIT
2.
Operation
For effective coagulation on a large growth,
length of time is more important than the amount of
current. The Specialist graphic indicates suggested
power
trode indicated. Emphasis again is 'placed on the
many procedures where variations in power settings depend largely on the experience and judgment of the surgeon. The process of coagulation is
dependent on areas of highest current concentra-
tion where dehydration and carbonization will occur
first. Skilled surgeons in their procedures have
found short times with high power are not as effective as low power and longer times if deeper penetration is desired.
trode, coagulation begins at its point, this being the
area of highest current density. Dehydration occurs
and loss of conductivity at this point forces current
to dehydrate successive areas of less penetration.
While the current is left on, the ascending area of
coagulum, broadens in a cone-like fashion until it
becomes evident at the surface. Ball or flat blade
electrodes in contact with tissue for coagulaton
purposes depend on area of contact, power setting
and time to produce the clinical requirement. The
effect is a dehydration of descending nature towards
the dispersive electrode.
adjustinents or settings for the type of elec-
In applications of a penetrating needle elec-
DESICCATION AND FULGURATlON
Desiccation is usually a bi-terminal technique
with dispersive electrode. Many surgeons find the
amplitude controlled cut with hemostasis waveform
ideal for this precise form-of coagulation. You will
find that spark intensity diminishes as the cut power
control is turned to lower settings.
the short fine spark appropriate for dermatology
and facial surgery.
In the process of fulguration, the coagulation
current jumps from a pointed active electrodeto the
large mass of the patient. Fulguration being a surface dehydrator, becomes self-limiting, since dehydrated areas are non-conductive to currents. The
same effect happens if the active electrode becomes
coated with coagulum.
The effectiveness of desiccation and
tion are superficial, and therefore are preferred
when cosmetic results are important.
Phis produces
fulgura-
BOVIE SPECIALIST ELECTROSURGICAL UNIT
3.
Safety & Precautions
SAFETY
&
PRECAUTIONS
GENERAL PRECAUTIONS
Certain general precautions are necessary in the use of any electrosurgical unit.
Read and observe them carefully.
The BOVIE Specialist Electrosurgical unit
is sold only for use by qualified physicians
and surgeons. The observance of safe
establishedmedicalpractices
and
tial to its proper use, otherwise, there are
possibilities of injury to patients or operators.
Operator and patient safety are of prime impor-
1.
tance in electrosurgical applications. Due to the
necessity of high voltages in any
cal instrument, added precautions have been
taken in the BOVIE Specialist.
In bi-terminal techniques, proper application of
2.
the dispersive plate with conductive gel usually
will require less power for good clinical results.
The active cable, regardless of accessory used,
3.
should NOT be coiled, but let droop away from
the patient and operator and preferably away
from large metal masses.
--
The safe and effective use of elecfro-
surgery is dependent, to a large extent,
upon factors under the control of the
operator and not entirely controllable by
the design of this equipment. It is imperative that the instructions supplied with this equipment be
read, understood and followed in order that safety and
effectiveness be enhanced.
is essen-
electrosurgi-
With present-day techniques of administering
spinal, intramuscular, oral and rectal anesthetics,
the surgeon or anesthesiologist has a wide choice
from which to select an appropriate anesthesia for
any electrosurgical procedure.
Useof local anesthetic may require an increase
in power if the operating field contains a heavy fluid
content of injectable anesthetic. It is generally better to inject an anesthetic a little distance from the
lesion itself, allowing it to serve more as a block
anesthesia rather than injecting directly under the
lesion.
PREVENTION OF BURNS
Accidental Ignition
When a flammable fluid, such as alcohol or
ether, is used to cleanse the field preparatory to
surgery, it is well to remember that there is a possibility of igniting any gas or residual liquid by a spark
from the electrode. When flammable fluids or solvents are used, allow sufficient time for complete
evaporation and be sure that drapes, dressings,
coverings, clothing, etc., surrounding the field are
not saturated with the liquid.
of
Flammable Fluids
Accidental Ignition of Flammable Gases
The risk of ignition of flammable gases or other
materials is an in
surgery which cannot
device design. Precautions must be taken by
user to restrict flammable gases and liquids
whether from anesthetic or skin preparation agents,
or present in surgical drapes.
Disposable anesthesia hoses are conductive
and will burn if touched by an active electrode.
herent hazard in the use of Electro-
be entirely eliminated by
the
-
ANESTHETIC
The use of an electrosurgical apparatus imposes
some limitations on the type of anesthetics which
can be safely used. Choice of anesthesia should be
made with full consideration of the danger of using
electrical sparks in the presence of explosive gases.
all
The best rule is to avoid
and it should be'recognized that many commonly
used inhalant anesthetics
cially so when used with oxygen.
flammable anesthetics;
are
flammable - espe-
Avoidance of Internal Body Gases
Another precaution which must be observed is
the avoidance of any flammable gases within the
body. This is especially true in body cavities. It
should also be kept in mind that colonic gases are
flammableand should bedispersed with nitrogen or
carbon dioxide before applying energy in the colon.
BOVIE SPECIALIST ELECTROSURGICAL UNIT
3.
Safety
PATIENT
a pacer since high-frequency
with its action. This is particularly true of the
demand type pacer which depends on theabsence
of signal for its triggering. Interaction with pacers
and other heart contact
by placement of the dispersive electrode so that the
high frequency energy path is remote from the area
surrounding the heart and any heart contacting
devices.
(h
Precautions
WITH CARDIAC PACEMAKER
It isvery important to know if the patient is using
energy can interfere
devices can be minimized
GROUNDING THE UNIT
Be sure that the chassis of the unit is grounded
1.
in accordance with grounding instructions,
-
otherwise, there is possibility
-
of shock to patient or surgeon. Grounding
instructions are identified in the "Introduction"
section.
Do not increase power output before checking
2.
for obvious defects or misapplication. Apparent
low power output or failure of the
cal equipment to function correctly at otherwise normal settings may indicate faulty application of the dispersive electrode, or failure of
an electrical lead.
Electrosurgical leads should be positioned so
3.
they cannot contact the patient or other leads
connected to the patient; nor should they run
parallel, close to other leads.
remote but real
Electrosurgi-
PREVENTING HIGH-FREQUENCY SKIN
BURNS
Follow directions and recommended practices
3.
for the preparation, placement, surveillance,
removal and use of any dispersive electrodes.
The use and proper placement of a dispersive
electrode is a key element in the safe and effective use of Electrosurgery, particularly in the
prevention of burns.
4.
Because of the risk of burns, needles should not
be used as dispersive electrodes.
To minimize the possibility of localized burns
5.
resulting from stray electrosurgical currents,
the patient should not be allowed to come into
contact with grounded metal parts or other
large conductive surfaces.
Physiological monitoring electrodes should be
6.
placed as far as possible from the
cal site and the dispersive electrode. This will
reduce the risk of burns at the monitoring site.
Protective impedance incorporated into the
monitoring leads may further reduce the risks
of such burns. Needles should not be used as
monitoring electrodes during such procedures.
The use of Safety Glasses or other eye
protection is recommended to protect the
surgeon from sparks
is used in conjunction with Endoscopic
instruments.
ELECTROSURGERY
DALITY FOR CIRCUMCISION PROCEDURES.
IS
NOT AN APPROPRIATE
electrosurgi-
when the Specialist
MO-
Accidental burns are possible from the disper-
1.
sive electrode (if improperly prepared or applied) or from the active electrode if it is carelessly handled or laid on the patient when not in
use.
The dispersive electrode must be kept clean
2.
and smooth and should always be applied with
a generous application of
Conductor. Wet towels or soap lather should
not be used, as conductive agents, as they
might dry out, resulting in a
skin burn to the patient. Under no circumstances should the dispersive electrode be applied
over matted hair or hard scar tissue.
BOVIE
Liquid or Gel
highifrequency
BOVlE SPECIRLIST ELECTROSURGICAL UNIT
3.
Safety & Precautions
REVIEW OF ACTION STEPS FOR SAFETY
These steps should be observed for the
safety of the patient and operating personnel.
1.
Explosion Hazards
a. Avoid flammable anesthetic.
b. Avoid flammable prep solutions.
c. Remove gas from colon prior to internal
surgery.
2.
Shock Hazard
a. Ground equipment, not the patient.
b. If electrosurgery is essential on a patient
with a pacemaker, keep RF out of area of
pacer. Be prepared to shunt a demand pacer
with magnet and closely monitor patient
activity.
3.
Patient Burn
a. Use adequate area dispersive electrode for
bi-terminal procedures.
b. Avoid patient contact with extraneous
ground points when using mono-terminal
techniques.
c. Avoid hair and scar tissue under dispersive
electrode.
d. Do not place dispersive electrode at bony
protrusion.
e. Make skin contact uniform by using BOVlE
Liquid or BOVlE Gel Conductor.
f. Keep reusable plates clean.
g. Keep dispersive electrode as close to sur-
gery site as practical but on opposite side of
trunk or limb rather than adjacent so current
flows through body, not on skin.
R.
Do not
active electrode is in contact with tissue to
be cut or coagulated.
i.
Do not
patient tissue containing metal implants.
Localized heating may occur.
4.
Surgeon Burn
a. Wear eye protection when using
scope type instruments.
b. Avoid metal eyeglass frames.
c. Avoid metal eye pieces on scopes.
d. Use heavy duty rubber gloves.
e. Do not activate ESU unless active electrode
is in contact with tissue to be operated on.
The BOVlE Specialist method of activating only
one accessory function at a time eliminates the possibility of inadvertently laying down an active electrode that may become energized when another
accessory is used.
A hemostat, used in conjunction with coagulating currents, should be insulated at the point of
operator contact.
activate Electrosurgical unit unless
pass electrosurgical currents through
RF
on
NOTES
BOVlE SPECIALIST ELECTROSURGICAL
4.
Common Power Settings
UNIT
COMMON
POWER SETTINGS
POWER REQUIRED
The Cutting and Coagulating controls must be
set at the required power. The amount of power
required, either for cutting or coagulating, involves
a number of variables. To determine the best set-
tings, experience plus familiarity with the Specialist
and its electrodes is required. For a general rule and
guide, see the Power Setting Chart in this section.
With the fundamental principles understood, little
difficulty should be experienced in making the correct settings for different types of work. The degree
of hemostasis required with the cutting current is
selected by setting the Cutting Type selector.
Cutting Power Required Varies According to:
Nature of tissue to be sectioned. Fat or cartilage
1,
requires more power than skin or muscle. Scle-
rotic, fibrotic or cicatrical tissues will require
more power than softer tissue.
Depth of incision. A deep incision (with the
2.
same electrode and a given speed of cut)
requires more power than a shallow one.
2.
Type of electrode used. A heavy electrode, ball
or disc, will require a higher power setting than
pointed electrodes, due to the larger area of
tissue contact.
3.
Character of surrounding media. More power
will be required for coagulation under water or
in a bloody field than for csagulation in a reasonably dry field.
Coagulating Graphic
This graphic provides the skilled surgeon the
opportunity to recognize the approximate power
settings for the type of electrode used.
If the lowest possible power setting is used,
which will allow free cutting at a desired depth, there
will be a minimum of sparking and flashing at the
electrode. This prolongs the life of the operating
instruments and prevents charring and excessive
coagulation of the wound edges.
COAGULATING
Rate of speed at which cutting electrodes is
3.
moved. Fast cuts require more power than slow.
Slow cuts produce more hemostasis.
Type of electrode used. For a given depth of
4.
incision with equivalent speed of cutting. Power
required will depend on the size of the electrode
used. The thinner the electrode, the less power
required.
Coagulation Power Required Varies According to:
Length of time current is applied. Contrary to
1.
what might be expected, a lower power for a
longer time will give greater depth of coagulation than will a high power setting for a shorter
time.
COAGULATING POWER GRAPHIC
BOVlE SPECIALIST' ELECTROSURGICAL UNlT
4.
Common Power
Settings
With these fundamentals in mind, it can be seen that power settings are not fixed,
unalterable figures, but are subject to individual variation. Therefore, it should be
recognized that best results are attained when the power settings are altered to meet
the immediate or existing conditions.
COMMON POWER
CUTTlffi COAGULATING
f
PURE
Cur
\
Power settings listed
are
approximate.
Keratoses
1
Aborting Boils
Sebaceous Cyst
Plantar Warts
Skin Tumors
NOSE AND THROAT SURGERY
Tonsil Tags
Incision of
Abscesses
7
Epistaxis
Nasal Polyps
(electrocutting)
TYPE
CUT
WlTH
l€haxTrns
I I
PURE CUT
CUT/HEMO
CUT/HEMO
1
'0
POWER
10'
\
J
4-5
3
3
SETTINGS
Remove lesions with sharp curet.
Treat base with fulgurating or desiccative current.
3
3
3
4-5
3-4
Insert coarse needle into center of
necrotic area.
Insert needle into center of cyst.
Use loop. Cut
rotate loop
ulate.
I
Use loop electrode.
Use heavy pointed rod, straight or
curved. Use ball for more superficial
destruction.
Use coarse needle. Slow cut produces
more coagulation of wound edges
and prevents premature closure.
Use ball electrode in contact with surface. Avoid contact with metal
soeculum.
Place loop over polyp at
Apply power and cut through
light pressure. If necessary, lightly
coagulate base.
180"
ELECTROSURGICAL
into center of wart and
Use needle to coag-
UNlT
~ts pedicle.
uslng
BQVIE SPECIALIST ELECTROSURGICAL UNIT
4.
Common Power Settings
COMMON
f
WRE
CUT
\
Power settings listed
arn
gnnrn~imnt~
U,"
L.p,p,,"
PROCEDURE
Nasal Polyps
(Coagulation)
PROCTOLOGY
Hemorrhoidectomy
Anal Fissurectomy
Polypectomy
TYPE
,.,..,-.-.
CU~
NG
CUT
WITH
PSIS
CUTTING TYPE
CUT/HEMO
CUT/HEMO
CUT/HEMO
POWER
POWER
CUTIPOWER
5
5
4
SETTINGS (Cont'd.)
COAGULATlNG
ELECTROSURGICAL
COAGIPOWER
1-2
6
5
4
COMMON PROCEDURE*
Use needle electrode. May also be
used with wire snare method of
removal.
Use blade electrode.
Cut with blade. Use clamp to seal
bleeder. Touch electrode to clamp
to coagulate.
Use blade electrode for subcutaneous tissue.
UNIT
The blank chart below offers the surgeon space to keep notes on special
procedures not listed above. The operator is encouraged to use these notes
for future reference.
'See References, Page
500007
26.
17
BOVlE SPECIALIST ELECTROSURGlCAL UNIT
4.
Common Power Settings
OUTPUT POWER VS.
DIAL
SETTING
TYPICAL POWER (AT
4QQ
OHMS LOAD)
NOTE,
The above power chart is a typical output characteristic
the BOVlE Specialist. Actual output power measurements
may vary with type of test equipment used and methods of
circuit connection. See Service Manual for output power
calibration.
of
BOVlE SPECIALIST ELECTROSURGlCAL UNIT
4.
Common Power Settings
ELECTRICAL SPECIFICATIONS
This equipment is intended to operate at an
input voltage and frequency range as indicated on
the nameplate attached to the back of the unit.
lnput Voltage:
115
Rated Input
Operational Range
Input Current 3.2A
Operating Frequency 1.75 MHz
Open Circuit Voltage
Output Power'
.................
.....
90-130 Vac, 50/60 Hz.
.....................
................
(Crystal Controlled)
.......
................
(True RMS Power) into a 400 Ohm Non-
Inductive Load (Pure Cut Model)
+
10% Watts (True RMS Power)
50
+
10% Watts (True RMS Power)
36
4000V Peak to Peak
into a 400 Ohm Load
(Cut with Hemostasis)
into a 400 Ohm Load
Vac, 60 Hz.
@
115V
+20% -10%
75
+
10% Watts
(Coagulation)
MECHANlCAL SPECIFICATIONS
Dimensions:
Width 10.00"
Height 4.75"
Depth 14.25"
Weight 20 lbs. net
Length of Power Cord 10'
Length of Footswitch Cord 10'
................................
...............................
................................
.............................
(Unit and Accessories)
......................
.................
LIMITATIONS OF EQUIPMENT
This unit has been designed to operate indefinitely at 20% operational duty cycle
40
sec. OFF) at half power (5 Dial Setting) pure cut
into a 400 Ohm load.
(10 sec. ON and
*All output power ratings are for
volts/60
Hz.
input supply potential.
115
MOTES
EXPERIMENTS IN ELECTROSURGERY2
PRELIMINARY EXPERIMENTAL WORK
BOVlE SPECIALIST ELECTROSURGICAL UNIT
5.
Experiments
in
Electrosurgery
Before attempting actual electrosurgery, it is
advisable to experiment with use of the
cialist on a piece of meat. This is an excellent way for
the physician to acquaint himself with
the different currents, the control settings, manipulation of the footswitch and use of the various
electrodes.
It is suggested that a moist piece of meat (preferably flank steak due to its longitudinal grain) be
placed on the dispersive plate with the dispersive
plate plug inserted. The meat should be allowed to
1-
NEEDLE ELECTRODE
BOVlE Spe-
the action of
attain room temperature and should be fresh and
moist. If necessary, it may be moistened by injection
of
a
moderate amount of physiologic saline solution. The moisture content is important in order to
simulate living tissue as closely as possible, although
dead meat cannot be entirely comparable.
Electrosurgical techniques are not necessarily
simple; experience and care are essential for optimal
results. It is beyond the scope of this manual to
suggest specific surgical procedures, the nature of
which require skilled surgeons.
LOOP ELECTRODES
STRAIGHT BLADE ELECTRODE
-
-
BALL ELECTRODE
c
DISC ELECTRODE
STAINLESS STEEL COAGULATION ELECTRODE
ANGULATED BLADE ELECTRODE
TYPES OF ELECTRODES
?ibid.
Page
11
-15
BOViE SPECIALIST ELECTROSURGICAL
5.
Experiments in Electrosurgery
EXPERIMENTS
WITH ELECTROSECTION
UNIT
(Cutting)
Thecutting current will prove to be avery useful
modality in minor electrosurgical procedures, but
the successful use of this current requires more
understanding and skill than the purely dehydrating
currents. The physician will wisely familiarize himself with the "feel" of the cutting current, the synchronization of hand and foot in the manipulation of
the electrode and footswitch, the proper selection
and application of electrodes, and the selection of
power settings suitable to the technique being
employed.
Application of the cutting current is always
terminal. In preparation for cutting experiments,
therefore, the dispersive electrode is connected to
the dispersive electrode receptacle of the
and the meat placed upon it. Set the Selector to
PURE CUT. Insert theelectrode into the chuck handle and connect to the white active receptacle of the
Specialist.
bi-
BOVlE
Pure Cut
CUT.
Place the tip of the electrode lightly in contact
with the meat and as the footswitch is activated,
draw the electrode through the tissue at about the
samespeed you would use for cutting with
Note that the current does the cutting, carrying the
electrode through the tissue with almost complete
lack of the resistant "feel" of a scalpel.
Lift your foot at the exact moment you complete
the cut and lift the electrode from the tissue. This
synchronization is important. If the current is turned
off too soon, the cut will be incomplete; if too late,
electrical arcing will follow the electrode from the
tissue, causing extra dehydration at that point. Similarly, unless the electrode starts to move immediately after the current is turned on, there will be a
wider depth of dehydration at
incision.
At this point, several cuts made at different
depths should be practiced with lower and higher
settings used to determine lowest power settings
required for desired results; increase the power set-
ting for deepest cutting, use less power for shallow
incisions-and try stopping and starting to practice
hand and foot synchronization.
the start of the
ascalpel.
Blade Electrode
flat blade electrode. The flat blade should always be
used for a "clean" incision which will heal by primary union if you do not cut too slowly. Set the CUTTING control at
-
For the first experiment, use a
5
and the CUTTING TYPE to PURE
CUT WITH BLADE ELECTRODE
Changing speed of the electrode drawn through
the meat will provide various amounts of
sis. A clean incision with minimum hemostasis
requires a faster cut with area of contact and type of
tissue dictating setting of cut power.
hemosta-
BOVIE SPECIALIST ELECTROSURGICAL UNIT
5.
Experiments in Electrosurgery
Needle Electrode
ments, substituting a needle electrode for the flat
blade. The needle, presenting a thicker cutting
edge, will produce greater dehydration on the edges
of the incision, with more resistance and, consequently, slower cutting at the same power setting. A
needle electrode is preferred for incising abscesses
or cysts where drainage is desirable and healing by
primary union is to be prevented by choice. Try
short cross incisions at a CUTTING power of 2, a
type of incision used particularly for an abscess or
cvst. A areater hemostatic effect will probably be
noticed
difficult to perform small incisions with great speed.
kith the needle electrode since it is most
Loop Electrode
tissue or looping off simulated neoplasms with a
loop electrode. Depending on the size of loop and
clinical effects desired, CUTTING power should be
set at 2-3 for scalloping, with higher settings required for larger or deeper areas. Loop and needle
electrodes tend to build up coagulum easily. After
several trials, cleaning or replacing the loop would
give more indicative performance. A small area of
the loop should be utilized for initial contact since a
larger area of starting contact could cause coagulation to occur, crusting the loop and making incisions clinically unpredictable.
-
Now, repeat the above experi-
-
Next, try "scalloping" out bits of
Cut with Hemostasis
The experiments carried out in electrosection
Pure Cut may be repeated with the CUTTING type
switch turned to CUT WlTH HEMOSTASIS. Cut
with Hemostasis is a blend of pure cut currents and
coagulating currents, and may require a slightly
higher power setting for each electrode used since
the hemostasis current must, of necessity, be a
pulsed waveform. Pulsing will reducecutting ability
unless the power control is increased to a setting
compatible with clinical requirements.
Comparison of parallel incisions on the meat in
PURE CUT and in the CUT WlTH
position will verify the ease of cutting in PURE CUT
and the tendency to drag slightly in CUT WlTH
HEMOSTASIS. Use one power control setting for
both modes of electrosection and compare the
clean incision of Pure Cut with the dehydration
occurring in Hemostasis.
HEMOSTASIS
EXPERIMENTS WlTH COAGULATION
Coagulation and fulguration are probably the
most used techniques with electrosurgical instruments in office practice. The BOVIE Specialist is the
forerunner of a new coagulation current waveform
which appears to be not only a cooler method, but
also has greater desiccation capabilities with less
power requirement. In coagulation, power levels,
timing, electrode size and skill of application are
requirements for good clinical results.
CUT WlTH LOOP ELECTRODE
Contact the tissue lightly with
the loop before turning on the current. Step on the
footswitch and start movement of the loop imme-
diately. If too much of the loop contacts the tissue or
it you wait too long with current on before moving
the loop, coagulation will retard or prevent cutting.
Cut into, through, and out of the tissue. It is quite an
art to bring the loop away from the
piece completely excised. The final thin tab of tissue
will resist severance unless the loop is handled just
right. Practice makes perfect.
The wire loop of the electrodes will bend to
various angles or curve to required shapes other
than round. There is no need to be equipped with
loops of varied shapes or angulation.
asmall section of
tissue with the
Needle Electrode
The uniqueness of the Specialist coagulating
current waveform can be appreciated if the first
experiments are initiated at low power levels. Insert
the needle electrode in the chuck handle, set
COAGULATING power at
electrode to a
noted that a ring of coagulated tissue will form at the
surface of the meat. If power is kept applied, spark-
ing will occur. Sparking under these conditions
indicates loss of conductive tissue and the coagula-
tion voltage now is applied to a higher resistance or
impedance. Unless superficial dehydration is the
clinical requirement, timing is important so that
necrosis is accomplished without excessive arcing.
1/4
inch depth. Apply power. It will be
1.5
and insert needle
Continued
. . . .
. .
.
BOVlE SPECIALIST ELECTROSURGICAL
5.
Experiments
in
Electrosurgery
UNIT
Turn off the current by releasing the footswitch
and withdraw the electrode. Cut a section through
the blanched circle and observe the tissue change
which has taken place. You will find that you have
produced an inverted cone of coagulum surrounding and extending beyond the depth of electrode
insertion.
Insert different sizes of needles to different
depths, varying the amount of power from
and noting the time required to produce a ring of
blanched tissue around the electrode. With examination of the sections, you will soon gain an under-
standing of the amount of coagulation to be ex-
pected from various amounts of power with different
depths of insertion of heavier or finer electrodes for
varied periods of time.
Next, try applying low power for a longer time.
Set the COAGULATING power at
trode to the same depth and apply the current until
blanching is obvious. At this low power, fifteen sections or more will probably be required. Upon sectioning the meat this time, you will seea more extensive mass of coagulum extending farther away from
the electrode and penetrating more deeply.
You have now demonstrated two methods of
electrocoagulation; first, the application of high
power for a short time to produce limited, accurately
controlled tissue destruction and, second, the
application of low power for a longer time to produce more massive coagulation with a single inser-
3,
insert the elec-
1.5
to 4,
tion of the electrode. Obviously, the first method is
generally preferable in the interest of conservatism,
accuracy and time saving. For coagulation of massive areas, multiple punctures at high power are
considered usually more desirable than a single or
fewer punctures at low power and for a longer time.
Blade Electrode
Blade electrodes commonly used for cut or
hemostasis are frequently used for coagulation and
fulguration. The ease of using the same electrode
for cutting and coagulation becomes evident since
electrodes do not have to be changed. The only
requirement is to actuate in the coagulation mode.
Here again, depending on the surgical procedure,
the Specialist and its coagulating graphic
the surgeon. Place a clean blade electrode in the
chuck handle and set COAGULATING power at
Place blade electrode on the moist surface of the
meat with about
When power is applied, a period of
will elapse before a coagulated area around the
blade appears. Coagulation time and power should
be determined by experimentation on the meat to
become familiar with its depth of coagulation ability. A cut through a coagulated area with a scalpel
will further acquaint the surgeon
depth of coagulation. Visual inspection of coagulated areas will help the surgeon relate the results to
actual surgery.
1/8
to 1/4 inch area of contact.
wtth the Spec~al~st
will assist
1-3
seconds
4.
COAGULATE
WITH NEEDLE ELECTRODE
BOVlE SPECIALIST ELECTROSURGICAL UNIT
5.
Experiments in Electrosurgery
Ball Electrode
Placing the ball in contact with the meat and
setting COAGULATING POWER at
areas and depths of necrosis which are related to
P
time applied and power setting. Hold the ball
trode in contact with the meat and apply power for
seconds. Move to a fresh area and apply power for
10
seconds. Finally, apply power in another location, in line with the other two test spots, for
second. Cut through the three coagulated areas
with a scalpel. Observe the difference in coagula-
6
will produce
elec-
tion. Longer time applications cause larger areas of
tissue destruction.
To achieve controlled superficial destruction,
try "brushing" the surface of the meat with a ball
5
electrode over a predetermined area. Section and
note the depth of penetration as evidenced by the
blanching. Vary the amount of power and speed of
1
moving the ball, noting on sections, how the depth
of destruction can be varied from afew thousandths
of an inch to any moderate depth required.
COAGULATE
Monopolar Forceps or Hemostat
In techniques involving the use of monopolar
forceps or hemostat, use the coagulating graphic as
a guide if the blade sizes compare in size to the
pictorial. Micro forceps must have the power greatly
reduced. Use the needle electrode setting as a start-
.
ing point. Monopolar forceps usually use bi-terminal
technique. Experiment with tissue grip, power and
time variations to become familiar with their use.
Hemostat techniques are similar to using
polar forceps. Use a hemostat, insulated to the
operator, with bi-terminal operation. Again, experiment until the required power setting is found for
the blade size used.
mono-
WITH BALL ELECTRODE
Bipolar Forceps
Footswitch controlled bipolar forceps can be
used with the Specialist. Bipolar forceps construction is such that one blade is the active electrode,
the other blade the indifferent electrode. This
arrangement has a small coagulation current path
and therefore, less resistance to current flow, lower
power is usually required. The white jack is for the
active electrode, the black jack is for the indifferent
electrode.
BOVlE SPECIALIST ELECTROSURGICAL UNIT
5.
Experiments in Electrosurgery
EXPERIMENTS
WITH FULGURATION AND
DESICCATION
Using a pointed electrode (preferably the heavy
skin needle), allow a stream of sparks one or two
mm. long to play from the point to the meat. Try this
with and without the dispersive electrode. Hold the
meat in your left hand to add the capacitance of your
body which will simulate actual treatment conditions. The spray of sparks will dehydrate the superficial layers of tissue quite rapidly and you will find
that the depth of destruction is self-limiting because
complete surface dehydration will insulate the current against further penetration. Some variation in
depth of penetration can be accomplished by varying the power and you will note that you will use
about one-half the power setting for bi-terminal
guration than will be required for mono-terminal
applications.
Using a needle electrode, try the CUT WITH
HEMOSTASIS current for desiccation. Touch the
meat with the needle and note the effect. At low
power settings, you will see a more precise effect
than possible with pulse controlled coagulation
current.
ful-
Do not cut or coagulate your hand. Do not
touch ground while unit is energized.
Your experience with these two applications of
high frequency dehydration will demonstrate their
particular usefulness in skin conditions.
SUMMARY
Operator skill, experience, and observations
establish confidence with any electrosurgical instrument. With continued use and expanded adaptability, the operator will find the
superior operatory help in the practice of surgery.
BOVlE Specialist a
PART NUMBER
ACCESSORIES
BOVlE SPECIALIST ELECTROSURGICAL UNIT
6.
ACCESSORIES & OPTIONS
ACCESSORIES
Electrode, Needle
Electrode, Rod
Electrode, Loop
Electrode, Ball
Electrode, Blade
Dispersive Electrode
Cable Assembly, Dispersive
Footswitch Assembly, Specialist
Accessory Package, Electrode
Active Electrode, Control Handle Adapter
Conductor, Gel
Handle, Chuck, 10 Ft. Cord
Accessories & Options
#
REQ.
OPTIONAL ACCESSORIES
4
6861
Tri-Mode (Bipolar) Adapter.
Plugs into front of Specialist unit.
Provides normal and reduced-spark
monopolar output plus completely
isolated bipolar output.
Disposable Dispersive Electrode
Disposable Electrode Adapter
Wall Bracket
Mobile Cart,
Adapter, Hand Control
Disposable Active Electrode, CHUCK
Cord
&
Banana Plug
4
Caster
Plug for Footswitch
,IT Handle with Blade
'These parts are not field serviceable.
Loading...