CESAR SEVILLA JEFE DE OPERACIONES
TOMA DE DECISIONES EN SU EMPRENDIMIENTO
6.2.1.
Calling up a program
Call up each of the selectable programs with the following procedure: 1. Press the program key 16/17 repeatedly until the corresponding
program is shown on the display.
2. Connect the instruments; see Chapter Connecting instruments, Page 35.
6.2.2. Changing the program
The preconfigured programs can be selected from "0-23". The
parameters of the preconfigured programs can be changed, and the new parameters can be saved. Only the special types of current cannot be changed. To do this, set parameters such as output, blend factor, coagulation mode and foot switch assignment and then store them by pressing the AUTOSTART 32 key and keeping it pressed.
The programs from "24-99" can be freely configured. These programs output standard types of current.
6 Operation
You can change the following factory settings:
Select Cutting settings
1. Press the key/display for „Monopolar Output 1“ 35 or „Monopolar Output 2“ 39 and select connection socket 1 or 2.
2. Press the power limitation key for monopolar cutting 3 or 4. –Or–
1. Press the key/indicator for "Bipolar Output 3" 44 or "Bipolar Output 4" 48.
2. Press the power limitation key for bipolar cutting 23 or 24.
Set blend factor
1. Press the key for the monopolar degree of scabbing 5/6. –or–
Press the key for the bipolar degree of scabbing 25/26.
2. Set the blend factor between "1-9" or to "0" for coagulation-free cutting.
Select current type for coagulation current
1. Press the key/indicator for "Moderate Coagulation" current 12 – or –
Press the key/indicator for "Forced Coagulation" current 13 – or –
Press the key/indicator for "Spray Coagulation" current 14.
2. Set the power limit for the monopolar coagulation current using the keys for power limitation for monopolar coagulation 10/11.
–Or–
1. Set the power limit for the bipolar coagulation current using the keys for power limitation for bipolar coagulation 30/31.
6 Operation
6.3. Program descriptions
The following recommended settings for standard programs are based on empirical values and must be verified in each individual case by the surgeon.
6.3.1.
Program 0 "Standard"
This program is used for monopolar/bipolar cutting and coagulation in standard applications.
6.3.2.
Program 1 “EndoLAP Bipolar Cut”
(Bipolar Cut only for ARC 350 and ARC 350L)
This program is used for bipolar cutting with preconfigured settings.
;
The key/display for “Monopolar output 2” 39 and “Bipolar output 4”48 are preconfigured.
6 Operation
6.3.3.
Program 2 “EndoLAP II Ligation”
(ligation only for ARC 350L)
• Only connection socket 3 supplies ligation current.
• If the software option “Ligation” is unavailable, this program provides the function “Standard Bipolar”.
This program is used for ligation in laparoscopic applications in which 2 monopolar instruments and 2 bipolar instruments can be connected. In this program, one instrument of the BOWA NightKNIFE®, LIGATOR®, and TissueSeal® series and a further optional bipolar instrument can be connected.
The performance output is preconfigured and is automatically adjusted. The sealing effect can be altered via the key for scabbing level 25 or 26. The set effect is displayed from 1 to 4 in the 7-segment display “Bipolar Coag” 29:
• Effect 1: For a bipolar coagulation of thin structures with the aid of a BOWA ligation instrument.
• Effect 2: The sealing of thin blood vessels and structures with the aid of a BOWA ligation instrument.
• Effect 3: The sealing of medium-sized blood vessels and structures with the aid of a BOWA ligation instrument. • Effect 4: The sealing of thick blood vessels and structures of
up to 7 mm with the aid of a BOWA ligation instrument.
DANGER
Blood loss due to incomplete blood vessel sealing!
X Deactivate the ligation instrument after completed sealing of blood vessels.
;
The key/display for “Monopolar output 2” 39 and “Bipolar output 3”44 are preconfigured.
1. Connect the ligation instrument to the HF device.
ª
After completion of coagulation, a pulsating acoustic signal sounds.ª
At this point only very low output can be used in the tissue. 2. Terminate activation of the ligation instrument.6 Operation
6.3.4.
Program 3 “Abdominal Ligation”
(ligation only for ARC 350L)
• Conventional instruments (such as handles) must not be used in the ligation mode.
Ligation in Program 3 is only possible with “Bipolar output 3” 43.
• If the software option “Ligation” is unavailable, this program provides the function “Standard Bipolar”.
This program is used in a wide range of surgical applications, e.g. gynecology and laparoscopy.
It facilitates permanent blood vessel sealing with the manual
instruments of the BOWA NightKNIFE®, LIGATOR®, and TissueSeal® series for large veins, arteries or tissue bundles.
Intended for:
• large-lumen veins, arteries or tissue bundles • use in combination with instruments of the
BOWA NightKNIFE®, LIGATOR®, and TissueSeal® series
Not intended for:
• tubal sterilization or sterilization by means of tubal coagulation
• dirty or defective electrode tips
The performance output is preconfigured and is automatically adjusted. The sealing effect can be altered via the key for scabbing level 25 or 26. The set effect is displayed from 1 to 4 in the 7-segment display “Bipolar Coag” 29:
• Effect 1: For a bipolar coagulation of thin structures with the aid of a BOWA ligation instrument.
• Effect 2: The sealing of thin blood vessels and structures with the aid of a BOWA ligation instrument.
• Effect 3: The sealing of medium-sized blood vessels and structures with the aid of a BOWA ligation instrument. • Effect 4: The sealing of thick blood vessels and structures of
6 Operation
DANGER
Blood loss due to incomplete blood vessel sealing!
X Deactivate the ligation instrument after completed sealing of blood vessels.
;
The key/display for "Monopolar output 1" 35 and "Bipolar output 3"44 are preconfigured.
X Connect the ligation instrument to "Bipolar output 3" 43 of the HF device.
6.3.5.
Program 4 “Argon Ligation”
(ligation only for ARC 350L)
If the software option “Ligation” is unavailable, this program provides the function “Standard Bipolar”.
In this program, open surgical interventions are carried out with the additional device ARC PLUS for argon electrocoagulation. When suitable instruments are connected, argon coagulation can be carried out with rigid electrodes and argon cutting.
This program is used in a wide range of surgical applications, e.g. gynecology and laparoscopy.
It facilitates permanent blood vessel sealing with the manual
instruments of the BOWA NightKNIFE®, LIGATOR®, and TissueSeal® series for large veins, arteries or tissue bundles.
Intended for:
• large-lumen veins, arteries or tissue bundles • use in combination with instruments of the
BOWA NightKNIFE®, LIGATOR®, and TissueSeal® series
Not intended for:
• tubal sterilization or sterilization by means of tubal coagulation
6 Operation
The performance output is preconfigured and is automatically adjusted. The sealing effect can be altered via the key for scabbing level 25 or 26. The set effect is displayed from 1 to 4 in the 7-segment display “Bipolar Coag” 29:
• Effect 1: For a bipolar coagulation of thin structures with the aid of a BOWA ligation instrument.
• Effect 2: The sealing of thin blood vessels and structures with the aid of a BOWA ligation instrument.
• Effect 3: The sealing of medium-sized blood vessels and structures with the aid of a BOWA ligation instrument. • Effect 4: The sealing of thick blood vessels and structures of
up to 7 mm with the aid of a BOWA ligation instrument.
DANGER
Blood loss due to incomplete blood vessel sealing!
X Deactivate the ligation instrument after completed sealing of blood vessels.
;
The key/display for "Monopolar output 1" 35 and "Bipolar output 3"44 are preconfigured.
1. Connect the additional device ARC PLUS.
2. Connect the argon handpiece to “Monopolar output 1” 36 of the HF device.
–or (only ARC 350L)–
Connect the ligation instrument to “Bipolar output 3” 43 of the HF device.
6.3.6.
Program 5 "Argon Open"
In this program, open surgical interventions are carried out with the additional device ARC PLUS for argon electrocoagulation. When suitable instruments are connected, argon coagulation can be carried out with rigid electrodes and argon cutting.
1. Connect the additional device ARC PLUS.
2. Connect the argon handpiece with the rigid probes to the ARC PLUS.
3. Connect the surgical handpiece to the HF device.
6.3.7.
Program 6 "Macro Plastic"
6 Operation
6.3.8.
Program 7 "Micro Plastic"
This program is used in the lower output range with fine electrodes for microscopic tissue structures.
6.3.9.
Program 8 "Local Anaesthesia"
This program is used for applications in which the patients are not anesthetized or given only local anesthetics and in which extremely low- energy coagulation current is used. In this program, the coagulation current is set with extremely low energy using keys 13 or 14. X Select the key/display for "Forced Coagulation" 13 or "Spray
Coagulation" 14.
6.3.10.
Program 9 "ENT"
This program is used for applications in the ENT field.
In this program, Dessicate IV is available as standard as moderate coagulation.
6.3.11.
Program 10 "Micro Pediatric"
This program is used in pediatric surgery with fine electrodes.
6.3.12.
Program 11 "Micro Neuro"
This program is used for microsurgical work in neurosurgery in the lower output range.
It facilitates extremely precise output control to 0.1 W and precise work for tightly restricted contact coagulation in bipolar coagulation.
The program is used for monopolar and bipolar application with fine needle electrodes or tweezers.
In program 11, the maximum output transfer is unlimited to ensure maximum settings.
X Please refer to the respective diagrams Mono CUT 300 W, Mono COAG 120 W, Bipolar CUT 150 W, and Bipolar COAG 120 W.
6 Operation
CAUTION
Risk of injuring patients due to excessive output transfer!
X Always check settings prior to activation.
6.3.13.
Program 12 "DryCUT"
This program is a technology used to generate a so-called dry cut. It is used in cardiac surgery, particularly in hemostasis of receding blood vessels in the area of the sternum.
In this program, a larger controlled arc can be generated via which significantly deeper coagulation can be achieved.
6.3.14.
Program 13 "SimCOAG"
The configured output applies to both output sockets and is distributed according to the tissue structure.
The program is used in the field of cardiac surgery for simultaneous preparation.
In this program, two monopolar connection sockets can be activated simultaneously to facilitate the simultaneous use of two manually switched instruments.
;
The key/display for “Monopolar output 1” 35 and “Monopolar output 2” 39 as well as the key/display for "Forced Coagulation" current 13 light up.X Connect the handpieces with finger switches to the output sockets 36/40.
ª
Both handpieces with finger switches can be switched on or off independently of each other.It is not possible to work in cutting mode and key/display 12 is deactivated.
6.3.15.
Program 14 "Chest"
This program is used in thoracic surgery.
In this program, a cutting current and forced coagulation are used. Maximum output is limited to 90 W.
6 Operation
6.3.16.
Program 15 "Mammaria"
This program is used in breast and heart surgery.
In this program, a cutting current and forced coagulation are used. Maximum output is limited to 90 W.
6.3.17.
Program 16 “Gynaecology Ligation” (ligation only for
ARC 350L)
This program is used for surgery in gynecology.
If the software option “Ligation” is unavailable, this program provides the function “Standard Bipolar”.
This program is used in a wide range of surgical applications, e.g. gynecology and laparoscopy.
It facilitates permanent blood vessel sealing with the manual
instruments of the BOWA NightKNIFE®, LIGATOR®, and TissueSeal® series for large veins, arteries or tissue bundles.
Intended for:
• large-lumen veins, arteries or tissue bundles • use in combination with instruments of the
BOWA NightKNIFE®, LIGATOR®, and TissueSeal® series
Not intended for:
• tubal sterilization or sterilization by means of tubal coagulation
• dirty or defective electrode tips
The performance output is preconfigured and is automatically adjusted. The sealing effect can be altered via the key for scabbing level 25 or 26. The set effect is displayed from 1 to 4 in the 7-segment display “Bipolar Coag” 29:
• Effect 1: For a bipolar coagulation of thin structures with the aid of a BOWA ligation instrument.
• Effect 2: The sealing of thin blood vessels and structures with the aid of a BOWA ligation instrument.
6 Operation
DANGER
Blood loss due to incomplete blood vessel sealing!
X Deactivate the ligation instrument after completed sealing of blood vessels.
;
The key/display for “Monopolar output 1” 35 and “Bipolar output 3”44 are preconfigured.
1. Connect the additional device ARC PLUS.
2. Connect the argon handpiece to “Monopolar output 1” 36 of the HF device.
–or (only ARC 350L)–
Connect the ligation instrument to “Bipolar output 3” 43 of the HF device.
6.3.18.
Program 17 "Gynecology Hystero"
This program is used in gynecology for hysterectomies.
6.3.19.
Program 18 "TUR-P Bipolar TUR"
(Bipolar TUR only for ARC 350 and ARC 350L)
• Both cutting and coagulation are possible in the bipolar application.
• Use the connection socket for monopolar instruments 40 for monopolar TUR.
• Use the connection socket for bipolar instruments 43 for bipolar TUR.
• In the bipolar application, the output is adjusted via the so- called “effect”. The higher the effect number (0 to 9), the higher the degree of coagulation.
• Only coagulation current is available at “Bipolar output 4” 47. • The standard bipolar functions are available for ARC 300 and
ARC 300G.
The shift sensor on the foot switch is locked in this program for safety reasons.
This program is used for underwater cutting in the transurethral resection of the prostate.
6 Operation
In this program, the resection snare is used for cutting and coagulation. Arc control technology generates the cutting effect with simultaneously minimized power output.
ARC control facilitates immediate cutting and prevents adhesion of the electrodes.
;
The key/display for “Monopolar output 2” 39 and “Bipolar output 3”44 are preconfigured.
X Connect the bipolar resectoscope to “Bipolar output 3” 43. X Connect the monopolar resectoscope to “Monopolar output 2” 40.
6.3.20.
Program 19 "TUR-BT Bipolar TUR"
(Bipolar TUR only for ARC 350 and ARC 350L)
• Both cutting and coagulation are possible in the bipolar application.
• Use the connection socket for monopolar instruments 40 for monopolar TUR.
• Use the connection socket for bipolar instruments 43 for bipolar TUR.
• In the bipolar application, the output is adjusted via the so- called "effect". The higher the effect number (0 to 9), the higher the degree of coagulation.
• Only coagulation current is available at “Bipolar output 4” 47. • The standard bipolar functions are available for ARC 300 and
ARC 300G.
The shift sensor on the foot switch is locked in this program for safety reasons.
This program is used in hemostasis with the underwater cut in
transurethral resection and in the surgical treatment of bladder tumors. In this program, the resection snare is used for cutting and coagulation. Arc control technology generates the cutting effect with simultaneously minimized power output.
ARC control facilitates immediate cutting and prevents adhesion of the electrodes.
;
The key/display for “Monopolar output 2” 39 and “Bipolar output 3” are preconfigured.6 Operation
6.3.21. Program 20 “Resection Bipolar“
(bipolar resection only for ARC 350 and ARC 350L)
• Both cutting and coagulation are possible in the bipolar application.
• Use the connection socket for monopolar instruments 40 for monopolar TUR.
• Use the connection socket for bipolar instruments 43 for bipolar TUR.
• In the bipolar application, the output is adjusted via the so- called "effect". The higher the effect number (0 to 9), the higher the degree of coagulation.
• Only coagulation current is available at “Bipolar output 4” 47. • The standard bipolar functions are available for ARC 300 and
ARC 300G.
The shift sensor on the foot switch is locked in this program for safety reasons.
This program is used in hemostasis with the underwater cut in transurethral resection with immediate vaporization of the prostate tissue.
In this program, the resection snare is used for cutting and coagulation. Arc control technology generates the cutting effect with simultaneously minimized power output. The “rollerblade electrode” is used to vaporize the prostate tissue.
ARC control facilitates immediate cutting and prevents adhesion of the electrodes.
;
The key/display for “Monopolar output 2” 39 and “Bipolar output 3”44 are preconfigured.
X Connect the bipolar resectoscope to “Bipolar output 3” 43. X Connect the monopolar resectoscope to “Monopolar output 2” 40.
6 Operation
6.3.22.
Program 21 "GastroCUT Pol" (optional for ARC 300)
This program is used in gastroenterology for the removal of polyps with polypectomy snares via flexible endoscopes.
In this program, polypectomy snares are used for cutting and coagulation. Arc control technology generates the cutting effect with simultaneously minimized power output.
ARC control facilitates immediate cutting and prevents adhesion of the electrodes.
The degree of coagulation increases with an increasing blend factor.
Three modes are available in this program: fast, medium, and slow. For further information on the “GastroCut” mode, see Chapter "GastroCUT" mode, Page 27.
;
The key/display for “Monopolar output 2” 39 and “Bipolar output 4”48 are preconfigured.
1. Connect the polypectomy snares to the socket for “Monopolar output 2” 40 (use an adapter if necessary).
2. Connect the foot switch to the HF device.
3. Activate the HF current via the yellow key of the foot switch for cutting.
–or–
Activate the HF current via the blue key of the foot switch for coagulation.
4. Set the coagulation level using the keys for scabbing level 5/6. 5. In the case of hemorrhages:
Press the key/display for “Forced Coagulation” current 13 or use a clip.
6. If necessary, remove the polypectomy snares and connect the argon probe with the argon unit ARC PLUS.
7. Press the key/display for “Spray Coagulation” current 14. 8. Press the blue key of the foot switch for coagulation.
6 Operation
6.3.23.
Program 22: "GastroCUT Pap" (optional for ARC 300)
This program is used for making incisions in papillae with a papillotome via flexible endoscopes.
In this program, the papillotome is used for cutting and coagulation. Arc control technology generates the cutting effect with simultaneously minimized power output.
ARC control facilitates immediate cutting and prevents adhesion of the electrodes.
The arc is reduced as the blend factor is increased.
Three modes are available in this program: fast, medium, and slow. For further information on the “GastroCut” mode, see Chapter "GastroCUT" mode, Page 27.
;
The key/display for “Monopolar output 2” 39 and “Bipolar output 4”48 are preconfigured.
1. Connect the papillotome to the socket for “Monopolar output 2” 40 (use an adapter if necessary).
2. Connect the foot switch to the HF device.
3. Activate the HF current via the yellow key of the foot switch for cutting.
–or–
Activate the HF current via the blue key of the foot switch for coagulation.
4. Set the coagulation level using the keys for scabbing level 5/6. 5. In the case of hemorrhages:
Press the key/display for “Forced Coagulation” current 13 or use a clip.
6. If required, remove the papillotome and connect the argon probe with the argon unit ARC PLUS.
7. Press the key/display for “Spray Coagulation” current” 14. 8. Press the blue key of the foot switch for coagulation.
6 Operation
6.3.24.
Program 23 “Argon Flex” (optional for ARC 300)
This program is used in argon electrosurgery with ARC PLUS. In this program, surgical interventions are carried out with endoscopic use of flexible probes with the additional device ARC PLUS for argon electrocoagulation.
;
The key/display for “Monopolar output 2” 39 and “Bipolar output 4”48 are preconfigured.
1. Connect the additional device ARC PLUS.
2. Connect the flexible probes to the HF device at “Monopolar output 2” 43.
Pos: 39 /679-BOWA/ARC 300/350/7 Bedienung/7.5 Menü-Programme @ 4\mod_1261040640397_6.doc @ 35109 @ 23333333333333
6 Operation