Cutting tissue without bleeding – the advantage of RF-surgery compared to the use of a normal scalpel – predestined this technique especially for minimally invasive and endoscopic surgery. An alternating current vaporises the tissue that comes into contact with the RF instrument, while simultaneously allowing the surface of the cut to get coagulated. Without bleeding, the view of the operation field stays clear and the surgery can be performed faster and safer. Endosmart manufactures flexible RF instruments made from nitinol, which expand the possibilities for minimally invasive RF surgeries.

RF surgeries use a high-frequency current to cut or coagulate tissue. As with electric welding, a current flows between two electrodes. Between the electrodes, a hot arc is created, which heats the tissue in the area, achieving the desired effect. RF surgeries can be performed under a liquid, air or nitrogen atmosphere.

Contrasting techniques

RF surgeries can be divided into two departments: the monopolar and bipolar technique. For the monopolar technique, one pole is the electrode of the instrument, while the second pole is the patient. To close the electric circuit, a neutral electrode has to be applied to the patient. However, the bipolar technique is safer for the patient because there is no neutral electrode necessary. Instruments for bipolar RF surgeries allow both electrodes to be integrated, differing from monopolar instruments. Since both electrodes have to come into contact with the area that is to be treated, it is not possible to cut tissue with a bipolar instrument under an air atmosphere. Bipolar instruments muct be used in a conductive liquid, such as saline.

Flexibility is the key

The use of nitinol enables Endosmart to manufacture flexible RF instruments that provide surgeons with greater opportunities. Introduced through the shaft of a rigid or flexible endoscope, the nitinol electrode resumes its curved shape inside the patient. This allows the surgeon to work around a corner, which would not be possible with standard inflexible instruments. By using nitinol as an electrode material, not only does it become easier for the surgeon, but more regions of the human body can be reached during minimally invasive treatment. This leads to faster recovery for patients, which reduces the total costs for treatment.

Aiding biopsy

Nitinol can be used for monopolar and bipolar instruments. Not only can nitinol be used for cutting or coagulating tissue, nitinol electrodes can also be used in the field of biopsies. Shaped as a small loop with a diameter of 4mm, the instrument is able to cut a biopsy with ease. After the biopsy has been detached, it is caught by pulling the loop into the plastic tube, therefore providing an easy removal through the endoscope channel.

Depending on the requirements of the customer, Endosmart can either develop and manufacture nitinol electrodes or entire RF instruments. The assembling is completed in a sterile environment, with packaging and delivery available in bulk or single packs.