PubMed · 8949023
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H Leyh. 1996. [Transurethral prostate electroresection].. https://pubmed.ncbi.nlm.nih.gov/8949023/
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PURPOSE: We review modern electrosurgical treatments for removing benign prostatic tissue based on an historical perspective of medical applications of electrical energy. MATERIALS AND METHODS: We reviewed historical reports and landmark observations concerning the evolution of medical applications of electrical energy in the literature, with a special focus on the development of principles pertinent to the transurethral electrosurgical removal of prostate tissue. RESULTS: Modern transurethral electrosurgery of the prostate in a fluid medium has been well founded on key electrosurgical principles. Traditionally, the best clinical results and the least complications have been obtained through an understanding of the important precepts of this form of energy. These precepts have included distinctions between the reliability of effect and safety with direct and alternating current, and how different tissue effects can be achieved, either with selective current modes (cutting and coagulating waveforms) or by varying the size and configuration of the active electrode and its application time. CONCLUSIONS: This review chronicles the prominent role of electrosurgery in our efforts to debulk an enlarged prostate in patients with symptomatic voiding dysfunction. History reminds us that many of today's "new ideas" are merely updated variations on a theme, have often been tried before in a fashion by our predecessors and have for one reason or another fallen by the wayside. The conundrum of the perfect combination of electrosurgical variables that can fulfill our goal of making this an efficient and complication-free treatment continues to stimulate and challenge us as we move towards the next millennium.
Coagulation is an essential part of a surgical procedure, especially in neurosurgery. Beginning in the early years of this century, various techniques have been used to control bleeding at the surgical site. Over the years, these techniques have led to the invention of the bipolar coagulator and its modifications. Prevention of charring and tissue adhesion have been the goals of bipolar coagulator manufacturers all over the world; new techniques and different metallurgical compositions for the forceps have been tried to achieve these results. The NS2000, with its microprocessor-based controlled coagulative sequence, can be a good system for reducing tissue adhesion and charring under desired limits of low output power ranges provided by the system. Comparable results can also be obtained with the Malis CMC III and Synergy Malis systems with irrigation channels. These systems have the additional advantages of providing higher power outputs at lower panel settings and a maximum power output greater than that of NS2000. For neurosurgeons who need the additional option of cutting, the Malis CMC III is the recommended system.