The following is a listing of the Gynecology, Urology and Electrosurgery procedures and therapies where our medical devices can help you to provide excellent histology and safe, effective care for your patients.
Follow the product links below the procedure descriptions to get additional information on that product. For more specific clinical information on all our products please visit the Clinical Support Materials page.
Electrosurgical
Dissection - Electrosurgery is widely accepted for performing
surgical dissection procedures because of the ability to cut while
simultaneously providing hemostasis to reduce bleeding. However, the
common perception of electrosurgery is that it causes high tissue
temperature, which results in delayed healing, excessive scarring,
etc. This is indeed correct for standard electrosurgical electrode
configurations, but improved materials and manufacturing methods are
now used to dispel this stereotype.
The Epitome® electrosurgical scalpel design is intended to improve surgical results. A fine wire element surrounds the periphery of a non-conductive ceramic core. A spark plasma is formed around the wire to yield an ideal balance of precise tissue dissection without countertraction, and hemostasis with minimal thermal tissue injury.
Benefits in plastic and reconstructive surgery procedures include:
• Rapid and precise cutting through dense breast
tissue with minimal flap damage and scarring during reduction mammaplasty
and mastectomy.
• Rapid elevation of the abdominal flap and reduction or elimination
of seroma in abdominoplasty.
Benefits in head and neck surgery procedures include:
• Minimized thermal tissue damage to help
reduce post-surgical pain and recovery time after tonsillectomy and
UPPP.
• The concentrated cutting geometry allows the use of lower
power settings, reducing the risk of inadvertent facial nerve and
muscle stimulation.
• Reduced thermal damage during Tumor Removal provides an excellent
specimen for pathological assessment.
Using ultra-fine tip Opti-Micro™ electrosurgical needles, designed with exceptional geometry and an extremely small surface area, allows for high current densities at very low power settings. This results in precise dissection without adverse thermal effects and excellent healing results for small-scale procedures.
Benefits in plastic surgery procedures include:
• Excellent approximation and pinpoint control
for bilateral symmetry in blepharoplasty.
• Excellent approximation and cosmetic results, and minimal
nerve/muscle stimulation (“twitch”) during facelift.
• Thermal tissue injury is virtually eliminated, allowing excellent
healing results with minimal scarring.
Benefits in head and neck surgery procedures include:
• The practical elimination of thermal damage
to help reduce post-surgical pain and recovery time after tonsillectomy
and UPPP.
• The extremely concentrated cutting geometry allows the use
of very low power settings, minimizing the risk of stray electrosurgical
currents.
Epitome® Electrosurgical Scalpels
OptiMicro™
Microdissection Needle Electrodes
Endometrial
Sampling - Endometrial sampling is an important first-line procedure
for diagnosing the cause of Abnormal Uterine Bleeding (AUB). In-office
sampling with a disposable curette is the least invasive method for
getting an endometrial sample, and using the EndoCurette® sampling
suction curette, with its multiple elongated curetting ports on the
tip, provides a much more robust sample for histological assessment.
EndoCurette® Endometrial Sampling
Suction Curettes
Endoscopic
Irrigation - During cystoscopy, hysteroscopy and other delicate
endoscopic procedures bolus irrigation is used to improve visualization
and imaging by quickly clearing debris from the surgical field. Since
the surgeon knows exactly when and how much irrigation is needed it
is beneficial to provide that control to the surgeon. The elegantly
simple Pathfinder Plus™ bulb irrigator can be easily and precisely
operated with one hand, giving the surgeon control and allowing other
members of the surgical team to concentrate on other tasks.
The procedure involves simple preoperative insertion of Pathfinder Plus™ into the irrigation system. Pathfinder Plus™ maintains a slow continuous flush, controlled by irrigant bag height and/or pressure cuff. Surgeon compression of Pathfinder Plus’ bulb releases a highly controllable bolus flush. A gentle squeeze is effective in clearing large amounts of debris from the field, while 'fluttered' pulses can be effective for altering the position of objects in the field.
Pathfinder Plus™ Endoscopic Bulb Irrigators
Hysterosalpingography
(HSG) - In situations of unexplained infertility and recurrent
pregnancy loss, HSG is a radiographic imaging procedure used to help
diagnose the cause. In this procedure the balloon on the TVUS/HSG-Cath™
infusion catheter is tested for patency and the catheter is flushed
with contrast media. The tip of the catheter is then placed at the
cervical os and gently inserted to the desired depth so that the balloon
placement is fully intrauterine, aided by depth markings on the catheter
shaft. The inflation syringe is set to the 1.5cc mark and attached
to the inflation port, and the syringe plunger is fully depressed.
The inflation stopcock is now closed and the syringe is removed. The
catheter is gently pulled back until the balloon abuts the internal
os. The proprietary conical shape of the TVUS/HSG-Cath™ balloon
provides effective contrast media stoppage at the internal os without
patient discomfort. Water-based or oil-based contrast media is then
infused through the catheter injection port into the uterus. Permeation
of the contrast media through the fallopian tubes is monitored using
real-time x-ray. Spillage of the contrast media into the peritoneal
space rules out infertility due to tubal obstruction. HSG is also
indicated for verification of tubal blockage after placement of fallopian
insert coils in women who have undergone the Essure procedure.
Loop
Excision of the Transformation Zone - Treatment protocol for CIN/SIL
abnormalities has been refined to provide for the most effective disease
management. For example, non-surgical management – e.g., observation
– of lower grade lesions is considered essential to minimizing
obstetric risks such as pre-term delivery and cervical incompetence.
However, complication-free treatment of high grade disease is essential
for minimizing the risk of disease progression to cervical cancer.
When indicated, excision of the lesion must be accomplished with precision. Complete removal of the lesion (e.g., clear specimen excision margins) is essential for effective CIN management, yet excessive removal of non-involved cervical stroma can impact obstetric outcomes for those patients that desire future pregnancy. UtahLoop electrodes provide a rigid tungsten wire with adjustable support. Loop flex is minimized to provide highly controllable excision depth, and specimen count is minimized to contribute to effective histopathology.
Specific to UtahLoop® electrodes, the adjustable Safe-T-Gauge® is set to the desired maximum excision depth, often near 8mm. This provides an excellent reference for depth control, and prevents over-excision of healthy cervical tissue should the patient move during the procedure.
In some patients, endocervical involvement is
present, and traditional double-loop excision or “top-hat”
procedures are performed. With endocervical involvement, and when
exocervical component is roughly symmetrical, and the cervix is fairly
round, the C-LETZ Conization Electrode is an excellent means to achieve
complete removal of the lesion with a single specimen. A rotational
technique is used, meaning that the excised specimen is round rather
than square. Also, the special contoured shape of the electrode body
helps ensure consistency in excision depth, and the patented wire
configuration minimizes excision margin involvement, yet preserves
healthy tissue. Reference:
Miniconization procedure with C-LETZ conization electrode for treatment
of cervical intraepithelial neoplasia: a Swedish study.
UtahLoop® LETZ® Loop Electrodes
C-LETZ®
Contoured Conization Electrodes
UtahBall®
Ball Electrodes
CIN
Management Educational Materials
Finesse®
Electrosurgical Generators
Pelvic
Floor Stimulation in the treatment of Urinary Incontinence - Pelvic
Floor Exercises (Kegel Exercises) are often prescribed to strengthen
and tone the neuromuscular tissue of the pelvic floor in the treatment
of stress and mixed incontinence. However, these exercises can be
very difficult, or even impossible, for some patients to perform correctly.
Either because of extreme weakness of their pelvic muscles or difficulty
in identifying the correct muscles to exercise, these patients are
unable to perform manual pelvic floor exercise therapy.
The Liberty® Pelvic Floor Electrical Stimulation is a non-invasive treatment which activates natural nerve and muscle mechanisms in the treatment of urinary incontinence without active patient participation.
In women, the treatment consists of intermittent electrical stimulation of the pelvic floor nerve and muscle tissues using a tampon-shaped exerciser inserted into the vagina, or a smaller exerciser inserted into the rectum. The rectal exerciser may also be used in treating male urinary incontinence, usually following a prostate resection procedure. A common treatment schedule is 15 minutes, twice a day, every day or every other day. Following cure or improvement, a program of 2-3 treatments per week should be maintained.
Liberty® Pelvic Floor Electrostimulation
Systems
Saline
Infusion Sonography (SIS) - Trans-Vaginal Ultrasound (TVUS) with
saline infusion (aka Saline Infusion Sonography or sonohysterography)
is an in-office diagnostic ultrasound imaging procedure utilizing
saline infusion to distend the uterus for more accurate imaging versus
non-distended TVUS imaging. The procedure is indicated for abnormal
uterine bleeding (AUB), uterine fibroids or polyps, thickened or irregular
endometrium, recurrent pregnancy loss, pre/post - operative assessment
of uterine pathology, or failure of TVUS with any of these. In this
procedure the balloon on the TVUS/HSG-Cath™ infusion catheter
is tested for patency and the catheter is flushed with sterile saline.
The tip of the catheter is then placed at the cervical os and gently
inserted to the desired depth (intracervical or intrauterine), noted
by depth markings on the catheter shaft. The inflation syringe is
set to the desired volume and attached to the inflation port, and
the syringe plunger is fully depressed. The inflation stopcock is
now closed and the syringe is removed. If balloon placement is intrauterine,
the catheter is gently pulled back until the balloon abuts the internal
os. The proprietary conical shape of the TVUS/HSG-Cath™ balloon
provides effective saline stoppage at the internal os without patient
discomfort, and also minimizes image obstruction near the internal
os. 10-40ml of saline is then infused through the catheter injection
port to distend the uterus. This distention allows for more accurate
ultrasound imaging by separating the uterine walls, which allows for
good measurement of the endometrial thickness (for diagnosing hyperplasia)
and the identification of focal irregularities like fibroids, polyps,
congenital abnormalities, and cancers.
Surgical
Smoke Filtration - The smoke plume generated during electrosurgery,
electrocautery and laser surgery procedures can contain potentially
hazardous particulates and gases that can be harmful to the surgical
team and patient if inhaled. Use of the Filtresse™ surgical
smoke filtration and evacuation system can minimize this risk and
reduce odor while providing a clear view of the surgical site.
To begin the procedure, the filter pack and flexible tubing need to be attached to the Filtresse™ smoke evacuator. If desired, a 1/4" reducing nozzle can be attached to the end of the flexible tubing and to the smoke port of the speculum or hand piece to be used. The main power is turned on and the footswitch is used to verify air flow through the tubing. A speed control knob can be used to adjust the level of air flow. During the procedure, the distal tip of the smoke evacuation tubing or device should be held as close to the surgical site as practical in order to achieve acceptable smoke plume removal.
Although there are no regulations directly governing smoke evacuation in health care facilities, many organizations have published recommendations regarding the use of smoke evacuation systems. Among these publications, the following are frequently cited documents:
• NIOSH HC11 is a brief discussion regarding
the fundamentals of smoke plume evacuation. NIOSH
Hazard Controls - Control of Smoke from Laser/Electric Surgical Procedures.
• AORN has publications supporting smoke evacuation in the operating
room environment. A position statement specific to smoke evacuation
can be found at AORN
Position Statement on Surgical Smoke and Bio-Aerosols.
Filtresse™ Smoke Evacuation and Filtration
Systems
Filtresse™
Filters
Footswitches
Fuses
Tubing
Uterine
Laparoscopy - During diagnostic and surgical laparoscopy of the
female reproductive system, proper positioning of the uterus is critical
to the success of the procedure. The uterine manipulation procedure
begins by adjusting LUMIN’s articulating shaft for appropriate
uterine depth and flexion. With the balloon deflated, the LUMIN™
manipulator is inserted into the cervix until the locking nut on the
manipulator is flush against the cervix. The balloon is now inflated
to a level determined by the clinician, based on the size of the uterus.
After the laparoscope is positioned, the uterus is moved into the
appropriate position under direct visualization. The trigger mechanism
on the LUMIN™ manipulator articulates the manipulator shaft
forward and backward. Articulation can be locked with a locking lever.
To inject distention or contrast media into the uterus, the manipulator
is pulled back to seat the uterine balloon against the internal cervical
os. The syringe containing the media is attached to the female luer
connector on the manipulator. The selected media enters the uterine
cavity through the distal tip of the articulation shaft.
