Ms. Renee A. Merchel Profile

Renee A. Merchel

Research Engineer at ConMed Advanced Energy

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Proceedings Article | 11 March 2015 Paper

Characterization and literature review of bowel perforation injuring using argon beam coagulation

Kelli Barnes, Renee Merchel, Kenneth Taylor

Proceedings Volume 9326, 932609 (2015) https://doi.org/10.1117/12.2079780

KEYWORDS: Tissues, Argon, Intestine, Endoscopy, Thermal effects, Injuries, Colon, Plasma, Stomach, Microscopes

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INTRODUCTION: Argon Beam Coagulation (ABC^®) technology is used in conjunction with the ConMed ABCFlex^® Probe to provide non-contact hemostasis, coagulation, and tissue devitalization during endoscopic procedures. ABC provides a superficial tissue effect; however, there is a risk of bowel perforation. To better understand the settings that lead to perforation, this study reviews the literature and provides an ex vivo characterization of the ABCFlex Probe tissue effect at different settings when used at small distances. METHODS: Depth of thermal tissue effect was characterized to determine the effect of three parameters: power (W), distance from probe tip to tissue (mm) and application duration (s). 3 ABCFlex Probes were used to create 15 samples on ex vivo porcine small intestine for each combination of parameters. The depth of tissue effect for each sample was measured using a light microscope. RESULTS: Depth of tissue effect increases as power and application time increases. An increase of distance from the probe tip to the tissue results in a decrease in depth of tissue effect from a near contact to 1mm distance. Depth of tissue effect doesn’t significantly change from 1mm to 3mm distance. CONCLUSION: ABCFlex Probe can be used to achieve hemostasis in endoscopic procedures. Increasing power and application time increases the depth of thermal effect while increasing distance from the probe time to the surface of the tissue decreases the depth of tissue effect.

Proceedings Article | 11 March 2015 Paper

Introduction of argon beam coagulation functionality to robotic procedures using the ABC D-Flex probe: equivalency to an existing laparoscopic instrument

Renée Merchel, Kelli Barnes, Kenneth Taylor

Proceedings Volume 9326, 932608 (2015) https://doi.org/10.1117/12.2079616

KEYWORDS: Tissues, Laparoscopy, Argon, Liver, Robotics, Thermal effects, Surgery, Visualization, Robotic systems, Natural surfaces

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INTRODUCTION: The ABC® D-Flex Probe utilizes argon beam coagulation (ABC) technology to achieve hemostasis during minimally invasive surgery. A handle on the probe allows for integration with robotic surgical systems and introduces ABC to the robotic toolbox. To better understand the utility of D-Flex, this study compares the performance of the D-Flex probe to an existing ABC laparoscopic probe through ex vivo tissue analysis. METHODS: Comparisons were performed to determine the effect of four parameters: ABC device, tissue type, activation duration, and distance from tissue. Ten ABC D-Flex probes were used to create 30 burn samples for each comparison. Ex vivo bovine liver and porcine muscle were used as tissue models. The area and depth of each burn was measured using a light microscope. The resulting dimensional data was used to correlate tissue effect with each variable. RESULTS: D-Flex created burns which were smaller in surface area than the laparoscopic probe at all power levels. Additionally, D-Flex achieved thermal penetration levels equivalent to the laparoscopic probe. CONCLUSION: D-Flex implements a small 7F geometry which creates a more focused beam. When used with robotic precision, quick localized superficial hemostasis can be achieved with minimal collateral damage. Additionally, D-Flex achieved equivalent thermal penetration levels at lower power and argon flow-rate settings than the laparoscopic probe.

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