P29 Dissection using pulsed radiofrequency energy device (PlasmaBlade) is safe round implanted neuromodulation hardwares

Abstract

ObjectivesTo assess risk of damage to implanted neuromodulation hardware’s during dissection using the pulsed radiofrequency energy device (PlasmaBlade) in a simulated setting.DesignSimulated experiment.MethodsA simulated setting with fresh chicken breast threaded with different hardwires and PlasmaBlade in three configurations. Multiple substrates (wires), operators and observations were used representing typical hardware encountered in a functional neurosurgery service. Post dissection, the wires are inspected naked eye and under operating microscope. Induced current was assessed contemporaneously. A simple risk of physical and physiological damage is estimated.ResultsFive surgeons, of various grades, tested the PlasmaBlade at different CUT and COAG settings. Sixty dissections were undertaken. There was no structural damage and no induced current identified when PlasmaBlade was used at manufacturer recommended settings. At higher settings than would normally be used (CUT 6, COAG 5), there was opacification of insulation material of some wires (in 15 of 20 dissections; 75%), There was no dissolution of insulation even at this setting. Surgeons appreciated visibly lesser collateral damage to tissue and lesser smoke in the operative field using PlasmaBlade compared to conventional diathermy.ConclusionsWhen used at recommended settings, PlasmaBlade dissection did not cause any damage to implant wiring or tubing in this simulated setting. This report seeks to add to clinical data suggesting PlasmaBlade dissection is safe for dissection around DBS, SCS, VNS, ITB hardware.