Comparing Coblation® Technology to Others
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The practice of electrocautery which dates back to Hippocrates, is a crudely effective technology, useful for hemostasis, but lacking the ability to selectively target a precise area. Electrocautery effectively kills and removes the target tissue by essentially burning it.
Electrosurgery, first invented over 100 years ago, is more precise than electrocautery allowing the surgeon to target a specific area of tissue. The electric current passes through the tissue, causing the tissue to heat up, but not as dramatically as in electrocautery. There is demonstrated difference among varying types of radiofrequency-based devices. The size of the electrode, the type of current, the power setting and the amount of time the device is in contact with the tissue all affect the end clinical result.
Although Coblation® is a form of electrosurgery, it does not require current to flow through tissue to operate. In fact, during most common Coblation procedures, only a very small amount of current passes through tissue. Tissue ablation is obtained through the chemical etching action of the plasma.
When used in coagulation mode, localized activity of tissue is achieved by a larger amount of current passes it and by the direct reaction of the fluid in contact with the tip of the Coblation Wand. To learn more about this instrument and its use in Coblation technology, click here.
The ArthroCare® electrosurgical generator and other electrosurgical power sources have unique differences from both electrocautery and conventional electrosurgical systems. While all of the generators are radiofrequency generators, the ArthroCare generator is voltage-regulated; other generators are generally power-regulated. To better understand the difference between these two modes of operation, it is important to appreciate the concept of electrical power.
Electrical power is defined as the product of current (I) and voltage (V). Based on Ohm's Law, current is defined as the ratio of the voltage to the resistance (R); hence, Power (P) = VI = V2/R.
When a voltage is applied to an area of tissue to be treated, the resistance (R) increases over time. Therefore in this situation, for power-controlled systems, the voltage is constantly changed (increased) to ensure that the power (P) remains constant as the resistance increases.
For an ArthroCare generator, the voltage at each controller set point is fixed. Therefore, as the resistance increases during a tissue treatment, the power (i.e. thermal effect) is significantly higher during the first phase when the device is activated (less than a 10th of a second) and then rapidly decreases, limiting the thermal effects generated over time.
