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For sleep surgery in particular the CURIS® system offers fully automated tissue impedance control (AutoRF™) with an automatic cut-off and audio feedback indicating the tissue condition during activation.
The CURIS® 4 MHz operating frequency delivers highly focused surgical effects (cutting and coagulation) with minimal heat spread and the highest level of control.
The CURIS® is an all-in-one ENT surgery device: It is able to perform sleep surgery, do any cutting and coagulating necessary in ENT, and in plastic surgery and dermatology as well. It can even replace the laser.
Some competitors recommend to work without a return/patient/antenna plate and sell this proposition as a major feature of radiofrequency. Technically speaking any generator can be operated in this manner. However, there is a MAJOR SAFETY CONCERN involved for the patient if a generator is operated without a return plate in monopolar mode! And there are ALWAYS good reasons to USE A RETURN PLATE:
1. Current applied to tissue through an active electrode has to "find its way back" to the generator. If it is not "collected" by the return plate, it will "look for the easiest alternative way out". In that case anything that is earth-referenced, e.g. surgical equipment, furniture, etc., can become the alternative path. The technical term used is capacitive coupling. Touching an endoscope, a metal part of the chair or the operating table may result in burns! Such burns can occur on the skin, but also inside the body, even in areas far away from the surgical site, and they can DAMAGE VITAL STRUCTURES! Especially the office setting, when patients are awake and tend to move, thus changing the current path, can be dangerous.
2. The latest generator technology, e.g. the Sutter CURIS® radiofrequency generator, offers an additional safety feature to minimize the danger of burns. It constantly monitors the return plate (when a split patient plate is used) and immediately cuts off power delivery and gives an alarm signal when the patient plate becomes loose. Surgery can only be resumed when the return plate is properly re-attached.
3. To create the capacitive coupling effect, energy is needed. Working without a patient plate always requires more power than needed for the surgical effect. More energy can potentially cause more damage to the tissue and can cause burns more easily.
4. A properly attached patient plate closes the circuit and makes tissue effects homogenous throughout the procedure. Without the patient plate, cutting and coagulation effects may vary, depending on the patient's position, clothing, etc.
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