RT Journal Article
SR Electronic
T1 P29 Dissection using pulsed radiofrequency energy device (PlasmaBlade) is safe round implanted neuromodulation hardwares
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP e32
OP e32
DO 10.1136/jnnp-2019-ABN.102
VO 90
IS 3
A1 Paterson, A
A1 Kumaria, A
A1 Sitaraman, M
A1 Sabbubeh, T
A1 Ingale, H
A1 Basu, S
YR 2019
UL http://jnnp.bmj.com/content/90/3/e32.2.abstract
AB Objectives To assess risk of damage to implanted neuromodulation hardware’s during dissection using the pulsed radiofrequency energy device (PlasmaBlade) in a simulated setting.Design Simulated experiment.Methods A simulated setting with fresh chicken breast threaded with different hardwires and PlasmaBlade in three configurations. Multiple substrates (wires), operators and observations were used representing typical hardware encountered in a functional neurosurgery service. Post dissection, the wires are inspected naked eye and under operating microscope. Induced current was assessed contemporaneously. A simple risk of physical and physiological damage is estimated.Results Five surgeons, of various grades, tested the PlasmaBlade at different CUT and COAG settings. Sixty dissections were undertaken. There was no structural damage and no induced current identified when PlasmaBlade was used at manufacturer recommended settings. At higher settings than would normally be used (CUT 6, COAG 5), there was opacification of insulation material of some wires (in 15 of 20 dissections; 75%), There was no dissolution of insulation even at this setting. Surgeons appreciated visibly lesser collateral damage to tissue and lesser smoke in the operative field using PlasmaBlade compared to conventional diathermy.Conclusions When used at recommended settings, PlasmaBlade dissection did not cause any damage to implant wiring or tubing in this simulated setting. This report seeks to add to clinical data suggesting PlasmaBlade dissection is safe for dissection around DBS, SCS, VNS, ITB hardware.