Contraindications For Ob/Gyn Applications; Electrosurgical Procedures - Cooper Surgical LEEP PRECISION LP-20-120 Manual De Funcionamiento

5.2 Contraindications for OB/GYN Applications

• Pregnancy
• Known or suspected cervical changes secondary to DES (diethylbestrol) intrauterine exposure
• Acute or active inflammation of the cervix, endometrium, fallopian tube, ovary or
peritoneum (cervicitis, endometritis, tubo-ovarian inflammatory disease or pelvic
inflammatory disease)
• Invasive cancer that is visible on examination

5.3 Electrosurgical Procedures

This section provides only general information about the use of electrosurgical devices . Only the user
can evaluate the clinical factors involved with each patient and determine if the use of this equipment is
indicated . The user must then decide on the specific technique and procedure that will accomplish the
desired clinical effect .
LEEP PRECISION Generators are designed to allow the controlled destruction of tissue and are inherently
dangerous if operated improperly . REPORTED PROBLEMS DUE TO IMPROPER OPERATION DURING
ELECTROSURGICAL PROCEDURES HAVE INCLUDED:
• Inadvertent activation with resultant tissue damage at the wrong site and/or equipment damage
• Alternate current pathways resulting in burns where the patient, physician, or assistant is in contact with
exposed metal
• Explosions caused by electrosurgical sparking in a flammable gas mixture (i .e ., explosive anesthetic
gases and the inappropriate use of alcohol and other flammable liquids)
• Perforation and massive hemorrhage
A proper Patient Return Electrode pathway is extremely important during any monopolar electrosurgical
procedure . Every effort must be made to ensure that, throughout the electrosurgical procedure, an
adequate surface area is provided and remains in proper contact with the patient to reduce the current
density below a level that might cause inadvertent tissue damage where the Patient Return Electrode
has been applied .
5.3.1 Electrosurgical Tissue Effect
Delivery of continuous sinusoid waveform currents through a small electrode at appropriate power levels
can cause rapid heating of the intracellular fluids in the cells in close proximity to the electrode, turning these
fluids into steam . The significant increase in volume (approximately five times) causes cellular structure to
rupture, creating the clinical effect of CUT, with little or no hemostatic effort along the margin of the divided
tissue . Delivery of short duration pulses of R/F currents through a small electrode at appropriate power levels
can cause heating of intracellular fluids at a more gradual pace . This allows evaporation of these fluids
without rupturing the cellular structure, creating the clinical effect of desiccation or COAG with the division
of tissue .
By varying the pulse to an intermediate duration, it is possible to get a clinical effect to combine the clinical
characteristics of CUT and COAG, yielding the effect referred to as "blend," in which tissue is divided with a
desirable amount of hemostasis along the margins of the divided tissue .
WARNING
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