The plasma scalpel: a new thermal knife

Area of Science:

• Surgical Technology
• Biomedical Engineering
• Plasma Physics

Background:

• Traditional surgical cutting tools like steel scalpels can cause significant blood loss.
• Existing thermal knives offer alternatives but may have limitations in simultaneous cutting and coagulation.
• The development of advanced surgical instruments is crucial for improving patient outcomes.

Purpose of the Study:

• To describe a new thermal knife, the plasma scalpel, and evaluate its efficacy in tissue division and hemostasis.
• To compare the performance of the plasma scalpel against traditional and other thermal scalpels in preclinical and clinical settings.
• To assess the wound healing characteristics of plasma scalpel incisions.

Main Methods:

• A plasma scalpel was developed using a high-temperature argon gas plasma jet.
• Preclinical studies involved liver resections and muscle transections in canines, burn excisions in pigs, and wound healing assessments in rodents.
• Clinical efficacy was evaluated in 138 procedures across 96 patients, focusing on muscle transection, hepatic resection, and debridement.

Main Results:

• The plasma scalpel demonstrated effective tissue division and significant reduction in blood loss compared to steel scalpels in animal models.
• Histologic and breaking strength studies showed a 3-6 day delay in healing onset but ultimately comparable strength to steel scalpel wounds.
• Clinical use in 138 procedures showed minimal blood loss and faster hemostasis for muscle transections compared to electrosurgical scalpels.

Conclusions:

• The plasma scalpel is an effective thermal knife for simultaneous tissue division and blood vessel coagulation.
• While further clinical validation is needed, the plasma scalpel shows promise for reducing blood loss and improving hemostasis in various surgical procedures.
• The device's role in surgery requires additional research and demonstration of its benefits in diverse clinical applications.