Plasma Surgical is a privately held medical device company with headquarters in suburban Atlanta, Georgia, USA, with operations in the UK and France. The company was founded based on the work of plasma physics professor Nikolay Suslov, who developed a technology to apply plasma energy to surgically treat live tissue with minimal thermal damage. [1]
Cold plasmas are extensively used in industry for critical surface cleaning and have been proposed for multiple applications in Plasma medicine, including sterilization or decontamination processes. Thermal plasmas are characterized as being macroscopically hot and have widespread industrial use in materials cutting, and more recently broad use in surgical procedures.
The origins of a thermal plasma with the ability to both cut and coagulate tissue lie in the early studies by the late John Glover and his colleagues at the Indiana University in the mid 1970s. Glover and his team described the first plasma scalpel [2] [3] and compared this to the use of the steel scalpel and electrosurgery. Although effective as a surgical tool, this relatively simple two electrode handpiece device involved a relatively high gas flow and in early pre-clinical and clinical use there was evidence of argon gas in the circulation with the concomitant risk of gas embolism. No subsequent development ensued and no commercially available system arose from this early work.
In the mid 1990s, Nikolay Suslov invented a multielectrode system that generated plasma with a higher power density using a very low level of current. [4] This design used a low level DC current to generate a spectrally pure plasma flow in a small electrode group that facilitated the design of small diameter handpieces capable of generating a high power density of plasma flow using a very low argon flow of typically 0.2 - 0.6 L/min. This approach was developed further in 1999–2008 to create the company's flagship product.
The company's core product is the PlasmaJet system which utilizes an inert gas that is electrically excited to a plasma state, releasing three forms of energy: Light, Kinetic and Thermal. It is used for open and laparoscopic surgical procedures and the cutting, coagulation and removal of soft tissue by vaporization in gynecology, oncology, general surgery, and other areas. [5] and ovarian cysts, [6] and for tumor debulking. [7] The system was selected as the 2008 Innovation of the Year by the Society of Laparoendoscopic Surgeons. [8]
The PlasmaJet is currently cleared and available for use in the United States as a neutral plasma surgery system designed for cutting, coagulation and the removal of soft tissue by vaporization in open surgery and laparoscopic surgery. [9] The system also carries a CE mark and is approved and available for use in the European Union as a cutting and coagulation device in open and laparoscopic surgery.
In 1994, Professor Nikolay Suslov of Russia described a low voltage DC-excited multiple-electrode plasma surgery handpiece with low gas flow, signalling the possibility for effective clinical applications. Suslov's first US patent for plasma surgery device was published in 1998. [10] Following his findings and patent publication, Suslov and fellow professor Peter Gibson co-founded Plasma Surgical Limited in 2000. The company was headquartered in London, UK and had operations in Gothenburg, Sweden. The company introduced a prototype Neutral Plasma Coagulator at the American College of Surgeons Congress in 2002. [11]
In 2010 the company moved its headquarters from Europe to the US, establishing R&D, manufacturing and commercialization function in Roswell, Georgia, 20 miles north of Atlanta. [12]
In 2011, the company began broader commercialization efforts for the PlasmaJet in the US, Europe and Russia, with a total installed base of approximately 100 systems in hospitals and clinics. [13]
In 2012 the company received FDA clearance for an expanded indication for use, adding the removal of soft tissue by vaporization. [14]
Laparoscopy is an operation performed in the abdomen or pelvis using small incisions with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.
Cauterization is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, or minimize other potential medical harm, such as infections when antibiotics are unavailable.
Diathermy is electrically induced heat or the use of high-frequency electromagnetic currents as a form of physical therapy and in surgical procedures. The earliest observations on the reactions of the human organism to high-frequency electromagnetic currents were made by Jacques Arsene d'Arsonval. The field was pioneered in 1907 by German physician Karl Franz Nagelschmidt, who coined the term diathermy from the Greek words διά dia and θέρμη thermē, literally meaning "heating through".
The carbon-dioxide laser (CO2 laser) was one of the earliest gas lasers to be developed. It was invented by Kumar Patel of Bell Labs in 1964 and is still one of the most useful types of laser. Carbon-dioxide lasers are the highest-power continuous-wave lasers that are currently available. They are also quite efficient: the ratio of output power to pump power can be as large as 20%. The CO2 laser produces a beam of infrared light with the principal wavelength bands centering on 9.6 and 10.6 micrometers (μm).
A plasma torch is a device for generating a directed flow of plasma.
A surgical instrument is a medical device for performing specific actions or carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it. Over time, many different kinds of surgical instruments and tools have been invented. Some surgical instruments are designed for general use in all sorts of surgeries, while others are designed for only certain specialties or specific procedures.
Robot-assisted surgery or robotic surgery are any types of surgical procedures that are performed using robotic systems. Robotically assisted surgery was developed to try to overcome the limitations of pre-existing minimally-invasive surgical procedures and to enhance the capabilities of surgeons performing open surgery.
Electrosurgery is the application of a high-frequency alternating polarity, electrical current to biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue. Its benefits include the ability to make precise cuts with limited blood loss. Electrosurgical devices are frequently used during surgical operations helping to prevent blood loss in hospital operating rooms or in outpatient procedures.
Laser surgery is a type of surgery that cuts tissue using a laser in contrast to using a scalpel.
Dennis L. Fowler is the Vice President and Medical Director for Perioperative Services at NewYork-Presbyterian Hospital/Columbia University Medical Center. He is a pioneer in the field of endoscopic surgery and has been the first to perform numerous innovative laparoscopic surgical procedures, never before accomplished (NYP). Fowler was also the first general surgeon to use the Harmonic Scalpel, a device that uses wave frequency to divide the tissue and vibration to coagulate blood vessels.
Gingivectomy is a dental procedure in which a dentist or oral surgeon cuts away part of the gums in the mouth.
A gum lift is a cosmetic dental procedure that raises and sculpts the gum line. This procedure involves reshaping the tissue and/or underlying bones to create the appearance of longer or symmetrical teeth, thereby making the smile more aesthetically pleasing. This procedure is typically done to reduce excessively gummy smiles or to balance out an asymmetrical gum line. The procedure, also known as crown-lengthening, has historically been used to treat gum disease. It is only within the past three to five years that dentists have commonly used this procedure for aesthetic purposes. The practice of cosmetic gum lifts was first developed in the late 1980s, but there were few oral surgeons and dental practitioners available to perform the procedures. Gum lifts can also include bone shaping to reduce the prominence of the upper jaw and even out the tooth and gum ratio. This method provides permanent results, while simple gum contouring may result in relapse or regrowth of the gingiva.
A microplasma is a plasma of small dimensions, ranging from tens to thousands of micrometers. Microplasmas can be generated at a variety of temperatures and pressures, existing as either thermal or non-thermal plasmas. Non-thermal microplasmas that can maintain their state at standard temperatures and pressures are readily available and accessible to scientists as they can be easily sustained and manipulated under standard conditions. Therefore, they can be employed for commercial, industrial, and medical applications, giving rise to the evolving field of microplasmas.
Therapeutic endoscopy is the medical term for an endoscopic procedure during which treatment is carried out via the endoscope. This contrasts with diagnostic endoscopy, where the aim of the procedure is purely to visualize a part of the gastrointestinal, respiratory or urinary tract in order to aid diagnosis. In practice, a procedure which starts as a diagnostic endoscopy may become a therapeutic endoscopy depending on the findings, such as in cases of upper gastrointestinal bleeding, or the finding of polyps during colonoscopy.
Endometrioma is the presence of tissue similar to, but distinct from, the endometrium in and sometimes on the ovary. It is the most common form of endometriosis. Endometrioma is found in 17–44% patients with endometriosis.
Ovarian drilling, also known as multiperforation or laparoscopic ovarian diathermy, is a surgical technique of puncturing the membranes surrounding the ovary with a laser beam or a surgical needle using minimally invasive laparoscopic procedures. It differs from ovarian wedge resection, which involves the cutting of tissue. Minimally invasive ovarian drilling procedures have replaced wedge resections. Ovarian drilling is favored over wedge resection because cutting into the ovary might result in adhesions, potentially complicating postoperative outcomes. Ovarian drilling and ovarian wedge resection are treatment options to reduce the amount of androgen producing tissue in women with polycystic ovarian syndrome (PCOS). PCOS is the primary cause of anovulation, which results in female infertility. The induction of mono-ovulatory cycles can restore fertility.
Plasma medicine is an emerging field that combines plasma physics, life sciences and clinical medicine. It is being studied in disinfection, healing, cancer, and surgery. Most of the research is in vitro and in animal models.
A morcellator is a surgical instrument used for division and removal of large masses of tissues during laparoscopic surgery. In laparoscopic hysterectomy the uterus is cut up in strips, or morcellated, into smaller pieces inside the patient's abdominal cavity in order to extract from the abdomen. It can consist of a hollow cylinder that penetrates the abdominal wall, ending with sharp edges or cutting jaws, through which a grasper can be inserted to pull the mass into the cylinder to cut out an extractable piece.
Surgical humidification is the conditioning of insufflation gas with water vapour (humidity) and heat during surgery. Surgical humidification is used to reduce the risk of tissue drying and evaporative cooling.
Plasma coblation is a tonsillectomy procedure which involves the removal of tissue through radio frequency wavelengths. Coblation techniques have been present since the 1950s and have been developed so that errors can be removed to achieve a surgical techniques that is free from both defects and negative affects.
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