Electrosurgery Procedure Recanalizes Stenoses

A new treatment for stenoses of the central respiratory tract that is safe and offers few complications is electrosurgery applied by means of a rigid or flexible bronchoscope. A flexible scope offers more surgical freedom and gives the surgeon access to individual bronchopulmonary lobular segments. However, a rigid scope would be more appropriate for the retrieval of large volumes of blood or tissue or for the introduction of larger instruments.

Stenoses of the central respiratory tract are usually caused by benign or malignant tumors. To recanalize such stenoses, a procedure called Argon-Plasma Coagulation (APC) is employed in interventional bronchoscopy to destroy, coagulate, or reduce and excise pathologic tissue using high-frequency current. Instruments transmit this electric current via ionized argon gas in a noncontact process to the tissue. Compared to other interventional procedures, APC achieves an immediate shrinkage of the stenoses, bringing under control a respiratory condition that may be acute and threatening. APC has been successfully used for open surgery, gastroenterology, and ear-nose-throat applications.

APC comprises an electrosurgical unit (ERBOTOM ICC 350), the plasma coagulation unit (ERBE APC 300), and tracheobronchial probes and applicators. The system is the product of ERBE Elektromedizin GmbH (Tubingen, Germany). ERBE states that the APC procedure is largely free of carbonization and vaporization, with reduced release of aerosols. Since the penetration depth is limited, the risk of injury to adjacent structures is minimized and virtually precludes any risk of perforation.



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