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R H Quint

Publications and source records attributed to R H Quint.

5 recordsLinked to original sources
PubMed2001

Electrovaporization of prostate at power settings below 100 W.

BACKGROUND AND PURPOSE: Prostate electrovaporization has usually been performed at high power settings in the pure cut mode, using traditional electrosurgical generators. However, this practice is empirically based on the fact that a vaporization electrode is larger than a cutting wire loop. The role of the electrosurgical unit (ESU) in prostate electrovaporization has not been studied in detail. METHODS: In this Phase II cohort comparison study, we evaluated two different ESUs, coupled to the most clinically efficient vaporization roller electrode available in our opinion, to determine the lowest panel power settings that permit consistent tissue removal despite the desiccation normally produced during electrovaporization. RESULTS: One of these ESUs, the Excalibur Plus, permitted prostate electrovaporization at panel settings below 100 W for the first time, without compromising satisfactory early clinical outcomes. In a small number of cases, the spiked VaporTrode-Force 2 combination permitted effective electrovaporization at a lower power setting (180 W) than has previously been described when this ESU was coupled with the grooved VaporTrode, regardless of prostate size. During bench tests, a comparison of the actual power output curves in the clinically effective panel power setting range for each ESU revealed that the Force 2 overestimated the actual power output as impedance increased, while the Excalibur Plus underestimated it. This difference may explain why tissue could be vaporized at such low panel settings without the use of computer-controlled technology. CONCLUSION: These findings indicate a potential for improving the safety and efficiency of tissue clearance during prostate electrovaporization through future modifications in monopolar electrode design coupled with use of a generator that can either maintain or slowly increase actual power output as impedance increases at low panel settings. A Phase III clinical study would be justified on the basis of our preliminary results.

Benchmarking↗
PubMed1998

Applications of electrical energy to the prostate: an evolutionary perspective.

PURPOSE: We review modern electrosurgical treatments for removing benign prostatic tissue based on an historical perspective of medical applications of electrical energy. MATERIALS AND METHODS: We reviewed historical reports and landmark observations concerning the evolution of medical applications of electrical energy in the literature, with a special focus on the development of principles pertinent to the transurethral electrosurgical removal of prostate tissue. RESULTS: Modern transurethral electrosurgery of the prostate in a fluid medium has been well founded on key electrosurgical principles. Traditionally, the best clinical results and the least complications have been obtained through an understanding of the important precepts of this form of energy. These precepts have included distinctions between the reliability of effect and safety with direct and alternating current, and how different tissue effects can be achieved, either with selective current modes (cutting and coagulating waveforms) or by varying the size and configuration of the active electrode and its application time. CONCLUSIONS: This review chronicles the prominent role of electrosurgery in our efforts to debulk an enlarged prostate in patients with symptomatic voiding dysfunction. History reminds us that many of today's "new ideas" are merely updated variations on a theme, have often been tried before in a fashion by our predecessors and have for one reason or another fallen by the wayside. The conundrum of the perfect combination of electrosurgical variables that can fulfill our goal of making this an efficient and complication-free treatment continues to stimulate and challenge us as we move towards the next millennium.

Electrosurgery↗