Abstract
ObjectiveTo identify preoperative and intraoperative factors and conditions that predicts the beneficial application of a high-frequency electromagnetic field (EMF) system for tumor vaporization and coagulation.MethodsOne hundred three subsequent patients with brain tumors were microsurgically treated using the EMF system in addition to the standard neurosurgical instrumentarium. A multivariate analysis was performed regarding the usefulness (ineffective/useful/very helpful/essential) of the new technology for tumor vaporization and coagulation, with respect to tumor histology and location, tissue consistency and texture, patients' age and sex.ResultsThe EMF system could be used effectively during tumor surgery in 83 cases with an essential contribution to the overall success in 14 cases. In the advanced category of effectiveness (very helpful/essential), there was a significant difference between hard and soft tissue consistency (50 of 66 cases vs. 3 of 37 cases). The coagulation function worked well (very helpful/essential) for surface (73 of 103 cases) and spot (46 of 103 cases) coagulation when vessels with a diameter of less than one millimeter were involved. The light-weight bayonet hand piece and long malleable electrodes made the system especially suited for the resection of deep-seated lesions (34 of 52 cases) compared to superficial tumors (19 of 50 cases).The EMF system was less effective than traditional electrosurgical devices in reducing soft glial tumors. Standard methods where also required for coagulation of larger vessels.ConclusionIt is possible to identify factors and conditions that predict a beneficial application of high-frequency electromagnetics for tumor vaporization and coagulation. This allows focusing the use of this technology on selective indications.
Highlights
A wide range of electrosurgical devices has been developed during the last decades to facilitate tumor removal and/or hemostasis in surgery [1,2,3,4,5,6]
The clinical applicability of a new commercially available, high-frequency electromagnetic field (EMF) system has been demonstrated [12], and specific handling techniques and electrode tip configurations could be defined for optimal use [13]
When used in conjunction with the long malleable electrodes, the EMF system was found to be especially suited for long approaches to deep-seated lesions as both access and visibility were improved compared to surgery employing the shorter and more voluminous ultrasound aspirator
Summary
A wide range of electrosurgical devices has been developed during the last decades to facilitate tumor removal and/or hemostasis in surgery [1,2,3,4,5,6]. As most of these electrosurgical instruments are based on unique principles, they have to be carefully evaluated with respect to the possibility of added functionality and efficacy as a surgical adjunct [4,7,8,9,10,11]. This study was performed to identify preoperative and intraoperative factors and conditions that predict the beneficial application of this system in tumor vaporization and coagulation during brain surgery
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