Imagem e ressecção

Ablação por radiofrequência bipolar

A linha de produtos para ablação por radiofrequência bipolar da Arthrex® inclui as sondas ApolloRF™ usando o console Synergy RF e Footswitch.

Imaging and Resection

Product

As sondas ApolloRF® utilizam a tecnologia de radiofrequência (RF) bipolar controlada baseada em plasma para fazer a ablação do tecido rapidamente. Várias configurações de sonda estão disponíveis para uso em diversosd procedimentos.
Outras características incluem:
<ul>
 <li>Onda de radiofrequência otimizada para ablação eficaz de tecidos</li>
 <li>Os designs exclusivos dos eletrodos promovem o controle das bordas para um desbridamento preciso do tecido camada por camada</li>
 <li>Eletrodo ativo de peça única para maior durabilidade</li>
 <li>Aspiração otimizada para manter a clareza visual e evacuar partículas de tecido</li>
 <li>Controles de mão ergonômicos</li>
</ul>

Asheesh Bedi, MD (Chicago, IL), shares his use of the Apollo&lt;sup&gt;RF®&lt;/sup&gt; i90 probe when prepping for Bankart procedures.

Not Hidden

English  - en

video

Human

SpeedPearl: Bankart Preparation and Mobilization With the ApolloRF® i90 Probe

A key pearl when preparing for shoulder instability procedures and bankart repairs, is to utilize the Apollo I-90 probe to dissect between the capsule, labral sleeve and the bone. Given the bulkiness of previous RFA designs, inserting the RF into that plane was just not possible without damaging or ablating the capsule and labral tissue, and the dissection as a result was really only done with a periosteal elevator or shaver that generated bleeding and injured the soft tissue. The narrower head design of the I-90 permits full mobilization of that capsule or labral sleeve, or lesion, all the way to the muscle belly. This probe has given me precision with the 360 degree edge control to perform a nice, targeted dissection and mobilization. I've even used it with unstable chondral flaps or glad lesions that often occur on the glenoid at the time of these injuries.

Kaitlin Neary, MD (Boise, ID), demonstrates how to prepare the ankle joint for arthroscopic procedures using the ApolloRF® SJ50 probe.

SpeedPearl: Arthroscopic Debridement of the Ankle Using the ApolloRF® SJ50 Probe

The Apollo Sf50 probe is an essential device in my practice for ankle arthroscopy due to its precision in debriding, the joint allowing for optimal visualization and precise ablation. Visualization can sometimes be a challenge in the confined working area of the ankle joint. A key pearl when using the Apollo sf50 probe is to utilize its contained plasma field, particularly when debriding the anterior compartment. The controlled plasma edge feature on the 3.3mm electrode is designed to minimize the potential for impact to the neurovascular structures at the anterior aspect of the ankle, such as the anterior tibial artery and deep peroneal nerve. Its optimized aspiration and precise ablation allow for targeted removal of synovitis and scar tissue without excessive tissue disruption. This precision enhances surgical efficiency, providing a clear operative field while preserving vital structures essential for ankle function and recovery.

application/pdf

SynergyRF® Bipolar Ablation System With ApolloRF® Probes

ApolloRF® i90 Probe - Enhanced Ablation. Optimized Aspiration.

Comparison of Volumetric Removal Rate Between Arthrex ApolloRF® i90 Aspirating Ablator and Leading Market Competitors

Darren J. Friedman, MD (New York, NY), demonstrates the use of the ApolloRF® i90 probe for shoulder arthroscopy procedures.

ApolloRF® i90 Probe in Shoulder Arthroscopy Procedures

Darren Freedman, sports medicine physician at a New York City. We're here today to discuss the latest addition to the Apollo portfolio, the I-90. I'm going to introduce the I-90 into the anterior rotator interval portal. And you can see, due to the Torpedo shaped electrode, the ease of insertion in and out of the portal, in and out of the joint. This device also easily fits through a five millimeter cannula as well. As we look into the front of the joint, you can see the MJHL here, which is draped over the subscapularis. Due to the shape and the tapered electrode, it's very easy to get in between tissue planes that may be tight. And as we activate the device, it's easy to loosen up and release those adhesions anteriorly. And you can see how efficient this device is at releasing that tissue. So as we get even more medially on the scap, you can see how effective the I-90 is at taking down that MJHL for a capsule release and getting in between tight tissue planes. As you look at the lateral bicipital sling here or the medial bicipital sling. And if we wanted to taper that down, you can see the plasma activation affecting the tissue, taking down some of that redundant tissue as we move more superiorly above the subscapularis. If you wanted to do a rotator interval release due to the geometry of the electrode, it's very easy to work in the planes above the subscapularis and remove some tissue in this region. If you're going to be performing a subscapularis repair or performing a release anteriorly, as we're working more medially on the subscapularis, you can see some medial adhesions here towards the medial aspect of the rotator interval, getting towards the base of the coracoid. Once again, due to that anatomy and the design of the tip of this device, it easily navigates those tissue planes, allowing for a facile release of some of those adhesions as we work medially. And you can see we have a nice open release of that interval, complete excursion and mobilization of the subscapularis tendon. So introducing the I 90 into the joint. You can see the labrum here. Some degeneration degenerative labral tear to breed that. As I activate the device, you can see the plasma formation over the face and on the sides of the device. The plasma is really well contained with the I 90. And because of that well contained plasma, you've got something called edge control where if you just put the edge of the device against the target tissue, you get really focused, targeted treatment of that degenerative tissue. It's going to change my view. If you look more inferiorly some degeneration down low as well. Once again activating the device you can see that target tissue react taper down and get smoothed out. I'm going to look at the superior labrum. So it looks like the patient has degenerative slap tear. If we're going to breed a little of that superior labrum here. Same technique activAT the device just off the tissue, you can see that plasma form. And as it contacts the target tissue, you see those macroscopic changes in the tissue moving on to the to the glenoid. Some degenerative kind of grade two three chondral changes. This device works well when treating chondral lesions for achondroplastic due to that well contained plasma field, as the plasma contacts that diseased cartilage. You can see some macroscopic changes in the cartilage, allowing for debridement and stabilization of the lesion once again. The anatomy and the geometry of this device is great. You can see on the tip you get a really well defined field of plasma. And that tip can just hover over that cartilage lesion creating some changes in the tissue to breeding, removing the diseased tissue but preserving the healthier tissue underneath. So it really allows for precision of use because of that well contained plasma field. So if we look at the labrum now degenerative tear is stabilized. Free tissue has been tapered. Minimal impact on the surrounding tissue. And looking at the glenoid we can see that the cartilage lesion is stabilized. Less degenerative free tissue. After after treatment with the with the I 90 and last. You're looking at that rotator interval. We can see that subscapularis completely mobilized and released interval released in preparation for any potential subscapularis repair. Or if you're doing any work underneath the the coracoid. So in preparation for a set pectoral biceps tenodesis I-90 is very efficient at completing the tenotomy in the joint. I usually start about one centimeter off the stump the insertion and let the I-90 do do its work. Very clean, very efficient. Quick tenotomy in preparation for a tenodesis. All right. So we've moved up to the subacromial space. We've got a lateral portal. We're going to put our I-90 in there. You can see how easily that slides in with the Torpedo shaped electrode does not catch up on the tissue. And when I start my subacromial decompression I always start with the RF. It does a really good job of resecting tissue. This specimen does not have a significant amount of bursitis. I oftentimes will create a little bit of a window here in the deltoid fascia, which allows for ease of insertion of my other instruments if I'm going to be passing sutures through the rotator cuff. As we look medially, we can see some adipose on the undersurface of the acromion. So as we're doing our decompression and prep for a rotator cuff repair, you can see how efficient the I-90 is at resecting tissue removing the tissue. It does a really nice job of releasing tissue off the acromion. If you look at the face of the device, there's three large aspiration ports. And the beauty of that is that there's a fair amount of aspiration as you activate the device, which does two things. Number one, it minimizes the amount of bubbles, which is great. It also really reduces the the risk of clogging as we work medially back to the acromial spine. You can see it just kind of peels off the tissue, allowing for mobilization of the sided fibers of that rotator cuff. Visualization is clear. Minimal bubbles very efficient at resecting Excess tissue. In addition, the geometry in the tapered tip really allows for ease of passage medially, rarely gets held up or caught on tissue as we move laterally. You can see some adhesions anteriorly, and sometimes in individuals will have large retracted rotator cuff tears. You want to do a complete mobilization, and you can see it does a really nice job of breaking through those tissue planes, freeing up that underlying rotator cuff. You can see here some of that deltoid fascia is adherent anteriorly. We're going to open that up and release, which will make it easier for us to perform a rotator cuff repair. As we look laterally as we're preparing our lateral gutter for a double row repair, oftentimes that deltoid fascia will be adherent to the bone laterally. And once again, the geometry of the I-90 allows for ease of insertion into the lateral gutter. Rotate the device 90 degrees and release some of those adhesions down by the inferior part of that footprint, to allow for space and geometry and real estate to put our lateral row anchors in for a cuff repair. So plenty of space now after we've released that fascia in the lateral gutter. All right. So once again viewing from the lateral side instruments coming in posteriorly. We've completed our subacromial decompression. We've released back to the scapular spine. Our lateral gutter is released in preparation for our lateral row anchors. Essentially, the bone is ready for an acromial plasty if indicated. I think in wrapping up, the beauty of this device is it's unbelievably efficient at removing tissue in a volumetric fashion, but it's also extremely precise due to that well contained plasma field and the edge control. So this can be utilized when trying to resect tissue in the subacromial space and prep for a cuff repair or acromial plasty. But it can also be used around sensitive tissue like cartilage or labrum. Due to that edge control and that precision on the edge of the I-90.

SynergyRF™ Bipolar Ablation System

Arthrex presents the innovative synergy RF Bipolar ablation system with an Apollo RF probe. The system is unique with a proprietary enhanced waveform that transmits just the right amount of energy to ablate tissue quickly and coagulate bleeding vessels effectively. The cutting edge system uses a console, single use RF probe, and a footswitch with convenient pedals for complete control. The synergy RF probe has a handle that is ergonomically designed, with easy to push buttons, and specifically designed probe tip to allow surgeons to reach and remove tissue in a variety of arthroscopic procedures. The system operates at a specified radio frequency and generates an electrical field at the tip of the device. Electrical energy flows through saline, creating a chemical reaction that generates a high density energy field at the tip of the probe. The ultra thin plasma layer contains energized particles that have sufficient energy to break organic molecular bonds. These conditions ablate tissue only at the tip of the device at relatively low temperatures. The console has a user friendly touchscreen with product and activation modes, as well as adjustable settings. The synergy RF ablation system has the unique benefit of functioning as a stand alone system, or with the Arthrex Synergy Imaging platform, when connected to the Synergy Platform. The RF ablation system provides vital information that is easy to read by the surgeon and or staff. In addition, the system utilizes a metal proximity detection feature that suspends power to the RF probe when it is close to the scope and metal instruments to reduce equipment damage. The Arthrex synergy RF Bipolar Ablation System, setting the new standard for innovation in arthroscopic procedures.

Sondas ApolloRF®

Child (D)

O console SynergyRF pode ser integrado ao sistema de imagem Synergy (heads-up display) ou pode ser operado como uma unidade autônoma. As características incluem:
<ul>
 <li>Reconhecimento de sonda</li>
 <li>Interface de fácil uso</li>
 <li>Vários controles de ativação usando o console, interruptor manual ou pedal</li>
 <li>Configurações ajustáveis de ablação e coagulação</li>
 <li>Detecção da proximidade de metais</li>
</ul>

This animation features the ApolloRF® probe, part of the SynergyRF™ system. The probe has a specifically designed tip configuration that allows access to and removal of tissue in a variety of arthroscopic procedures.

ApolloRF® Probe

The SynergyRF single use probe has a specifically designed tip configuration that allows the surgeon to reach and remove tissue in a variety of arthroscopic procedures. The handle is ergonomically designed with easy to use buttons. The probe operates at a specified radio frequency and generates an electrical field between an active electrode and return electrode at the tip of the device. Electrical current flows through saline, which is an electrically conductive fluid. The electrical field interacts with the saline to create a plasma layer at the tip of the probe. This thin plasma layer contains energized particles that have sufficient energy to break organic molecular bonds. These conditions ablate tissue only at the tip of the device at relatively low temperatures.

Gautam P. Yagnik, MD, (Miami, FL) shares his impressions on using the SynergyUHD4™ system in conjunction with the DualWave™ arthroscopy pump and SynergyRF™ system.

SynergyUHD4™ System and ApolloRF® MP90 Probe

So here we're just using again as we switch devices radio frequency. The pump's responding. It's minimizing our. Our our pressure fluctuation, maintaining a nice, consistent visual field. Another advantage to the system and the integration is the heads up display. With the heads up display, I'm able to not only confirm which devices are hooked up, but I'm also able to really look at all the settings for the pump, including the flow rate, to ensure that I'm getting adequate flow here to maintain the shoulder in a nice distended position.

Rick Taft (Arthrex® Product Manager) demonstrates how to set up and operate the SynergyRF™ Bipolar system.

SynergyRF™ Bipolar System Setup

The synergy RF Bipolar Ablation System with Apollo probes is an advanced electrical surgical system that effectively and efficiently ablates and coagulates tissue in arthroscopic procedures. I would like to show you how easy it is to set up and use the system. The synergy RF system is provided with a power cord and console. The sterile, single use Apollo RF probes and optional Footswitch are provided separately. First, plug the power cord into the back of the console and then into 120 volt electrical outlet. Push the on off button on the left side of the console. Next, the Apollo probe is provided to the sterile field and the cord is plugged into the right side of the console. The default ablation and coagulation settings will appear on the console screen. Standard sterile suction tubing is provided to the surgical field, with one end connected to the probe suction connector, and the other connected to the waste canister or disposal equipment. If using the optional Footswitch, plug the connector into the Footswitch receptacle on the left side of the console. A Footswitch icon indicator will show up on the console screen. The ablation settings may be adjusted on the console screen. There may also be adjusted by the surgeon by pressing the black button on the probe handle. Or on the foot switch. You are now ready to use the system.

Memorial Hermann Surgery Center Staff (Houston, TX) shares how the Synergy product line uses imaging, resection, fluid management, and integration to improve their OR experience.

Improving Surgery Through the Synergy Product Line at Memorial Hermann

My name is Danita Fleming. I'm the administrator and CEO of the Memorial Hermann Surgery Center at Texas Medical Center. Our surgery center is located in the Texas Medical Center. We cater to high profile VIP type of clientele. Here we have seven operating rooms and two procedure rooms. We are multi-specialty. All of our surgery specialties use the Synergy Matrix platform. Gyn general Surgery and urology are the primary ones that use it in addition to orthopedic. Those surgeons love it compared to what we had before. Well, my name is Walt Lowe or Walter Arlow, M.D. I'm the chair of orthopedic surgery at University of Texas Medical Center in Houston, or UT health. You know, I've been through every arthroscopy system there is, you know, 25 years in practice doing pretty much just arthroscopic cases for the most part. And so the, you know, the synergy system is the best I've encountered. Optics are just spectacular. As arthroscopic surgeons, what we all want the most is to see great because you can't work if you can't see visual effect that we get from the synergy, I think is far superior to anything I've ever used. But really, I think where the rooms differentiate themselves is the integration of the system between, you know, handpieces, suction shavers, pumps, video, anything we want to bring up in the rooms, very easy to coordinate and very easy to see. And I not only think that makes us better at what we do, I think it makes it easier for us to teach our residents, to teach our fellows the things that are really important, besides just how to do the surgery. With the synergy. It's it was real easy to learn by yourself, and then it's easy to do it by yourself, which definitely saves times in the O.R.. Touch screen or drag and drop. There's two tabs on the system that you work from, and from putting images on the screen to just playing music in the background. For The Doctors, it's super simple from what we had before. I didn't know that was complicated until we got synergy. So getting something that was much more up to date and user friendly was a change I didn't know was so convenient for, I guess, the O.R. staff as a whole. Making the change over to Arthrex has helped us out tremendously. The biggest help for us is that we will be able to sterilize Sterilized the system in an autoclave. We're able to get have more sets ready to be more productive during the day, and you cut down on time and cost, being able to sterilize at a much quicker pace. The surgical team is much happier. They don't have to wait and try to have to explain to the surgeon, you know what we're waiting on or why we're delayed because everything's ready to go. The installation process went very smoothly without a hitch. It actually exceeded my expectations. A lot of planning, a lot of preparation, and for myself, even a little bit of contingency planning. Fortunately, we didn't have to use any of those contingency plans. I can truly be a spokesperson for the Synergy Matrix and for Arthrex, and let the administrators know that this is not another example of a product that overpromise and under-deliver. It truly does what Arthrex says that it will do. A company very interested in delivering the best products for the problems we're trying to solve as surgeons, and that's what I really love about the company, is if it's going to make it better patient care, then I know Arthrex is going to be 100% invested to try to get there and do it better than anybody else is.

This demonstration featuring the DualWave™ pump, SynergyRF™ console, and ApolloRF® probe shows how proper fluid management with bipolar RF devices can help maintain low fluid temperatures. The temperatures are recorded using FLIR thermal camera technology.

Ablação por radiofrequência bipolar

Sondas Apollo^RF®

Console Synergy^RF™

Ablação por radiofrequência bipolar

Sondas ApolloRF®

Console SynergyRF™

Sondas Apollo^RF®

Console Synergy^RF™