SUMMIT HILL LABORATORIES Tinton Falls Business Center 1 Sheila Drive Tinton Falls, NJ 07724 Phone: (732) 933-0800 Fax: (732) 933-0055 Email: sales@summithilllaboratories.com www.summithilllaboratories.com

VETROSON® V-10 BIPOLAR ELECTROSURGICAL UNIT

OPERATING INSTRUCTIONS

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TABLE OF CONTENTS

3 Frontpanel(controlfunctions,indicators,jacks)

4 Rearpanel(powercordapplianceentry,footpedal,toneswitch)

5 Monopolarandbipolar

5-6 Electrosurgicalcurrentquality

6-7 Powersetting(whatelectrosurgeryisandisnot;howtoadjust);Surgical

Technique

7 Initialpowersettings

8 Electrodes,handpiece,Flexibleindifferentplateandcable,andbipolarforceps

cleaningandsterilization

9 Electrode,handpiece,andcablesterilizationandcare

10PrecautionsPLEASEREADandOBSERVE!

11 Generalhintsandadvice

12 Coagulationhintsandadvice

13 Resolvingoperationaldifficulties

14 Warrantyandrepairs

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OPERATING INSTRUCTIONS

FrontPanel

VETROSON®V-10generatesradiofrequencyelectricalenergywhichmayinterferewithotherequipmentadverselyaffectingthatequipment.

1PowerON/OFF(I=ON,O=OFF)

2ACpower“on”indicator(lightsgreenwhenACpowerison)

3“Stabilizing”indicatorcomesonautomaticallyuponpowerswitchingontoallowunittostabilize.Afterabout

25secondsindicatorwillgooffandunitisready.Theunitwillnotactivatewhileindicatorison!

4RFactiveindicatorlightsyellowwhenenergyispresentattheselectedjacks

5Electrosurgicalcurrentqualityselect(“mode”a.k.a.“waveform”)

6RFPowercontrol(electrosurgicalcurrentquantity)

7Monopolaractivejack(monopolarhandpieceblackpluggoeshere)

8Monopolar/bipolarswitch(onlyonepairofjacksmaybeactivatedatatime)

9Bipolarjacks(bipolarcordplugsinhere(nopolarity)NEVERplugabipolarleadintoamonopolarjack!

10Monopolardispersivejack(currentreturnfromtheelectrode)V-10isanisolatedunitandwillnotworkin

monopolarwithoutthegroundpadpluggedinandproperlyplaced!

SymbolfortypeBFAppliedPart.Indicatesisolatedfromgroundathighfrequencyandahighdegreeofelectricalshockprotection.

Symbolforfloating.Isolatedfromgroundathighfrequencyandahighdegreeofelectricalshockprotection.

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RearPanel

1 Hospitalgradepowercordgoeshere(polarized,onlygoesinoneway)pushinfirmly2 Footpedalcablepluggoeshere(keyed,onlygoesinoneway)goesineasily,donotforce3 ActiveaudibletoneNormal/Softsetting(up=normal,down=soft)

Howgrounddispersivepadconnectstodispersivecable

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MonopolarandBipolarMonopolarelectrosurgicalcurrentisusedforincision,excision,andcoagulation.

Monopolarelectrosurgicalcurrententersthebodyatthesurgicalsitewhereaveryhighlyconcentratedcurrentdensityinducesheatendogenouslywithintheindividualcellsmakinguptissue.

Theelectrosurgicalcurrentreturnstothegeneratorviathedispersivepad(a.k.a.”indifferentpad”orNE“neutralelectrode”)overaverylargeareawithlowcurrentdensityandnoheatdevelopment.

Bipolarelectrosurgicalcurrentisusedforcoagulation.

Bipolarelectrosurgicalcurrentremainsconstrainedtotheimmediatevolumeoftissuegraspedbetweenthetipsofthetwoinsulatedforcepsblades.asshownhereforelectrocoagulationofavessel.

Inbipolaroperationelectrosurgicalcurrentdoesnottraversethebodyinordertoreturntothegeneratorasinmonopolaroperation

Bipolarelectrosurgicalcurrentmayalsobeappliedsuperficiallyontissuebyholdingtheforcepstipsapart.Theelectrosurgicalcurrentmaybeappliedin“hard”or“forced”manneror“soft”manner.

Usingthebacksideofcurvedforcepsheldapart,electrosurgicalmaybeappliedoverlargeareasbybrushingtheareawiththeforceps.Athincoagulumdevelopsinthatmethod,similartofulgurationbutwithouteschar.

ElectrosurgicalCurrentQuality(a.k.a.“mode”or“waveform”)

TheFINE(Filtered)currenthasthelowestdegreeofcollateraltissuedenaturingbutalsothelowestdegreeofconcurrenthemostasis.Itisusedwherecollateralheatandcicatrixformationareclinicalconcerns,i.e.,dermatologicalindications,cosmeticindications,biopsy,graftdonortissueharvesting,oculo-plasticindications,anddentalindications.

Crestfactorisameasureofcoagulationability(thehigherthenumberthemoreeffectivethecoagulationability)andCUThasacrestfactorof1.4.

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TheNORMAL(FullyRectified)combineselementsofcuttingcurrentandcoagulationcurrentsoastoprovidesignificantandeffectiveconcurrenthemostasisduringincisionandexcision.“NORMAL”isthe“generalpurpose”electrosurgicalcurrentandismostoftenused.

NORMALhasacrestfactorof1.9whichisaproveneffectivebalancebetweenconcurrenthemostasisandfasthealingduetominimalcollateraltissuedenaturing.

TheCOAGelectrosurgicalcurrentisusedtocontrolbleeding.Itmaybeappliedinmonopolarusingtheballelectrodein“hard”(a.k.a“forced”)applicationorelsein“soft”application.

CrestfactorinCOAGis2.7whichisrelativelymildyeteffectiveallowinggoodcontrolovertheeffectsandminimalcicatrixformation.

Bipolarmodeselectionautomaticallyselectsthiselectrosurgicalcurrent.

TheelectricalcharacteristicsoftheCUT,BLEND,andCOAGonanoscilloscopeareillustratedbelow:

FINENORMALCOAG(FILTERED)(FULLYRECTIFIED)

RFPOWERSETTING

Electrosurgeryisuniqueamongsurgicaltechnologieshavingcharacteristicswhichmustbetakenintoaccountwhenapplyingitclinicallyinordertoachievepositiveclinicaloutcomes.

1ElectrosurgeryisNOTCAUTERIZATION!Incauterizationheatisproducedoutsidetissueandthenbroughtintocontactwithtissuecausingsignificantcollateraltissuedamage.

ElectrosurgerydevelopsheatendogenouslywithintissuecellsandtheelectrodeDOESNOTgethotoutsidetissue.

Becauseelectrosurgicalcurrentreactswithtissuecellcontents,itwillNOTREACTwithinorganicsorelectricalinsulatorssuchaswood,plastic,orpaper.

2Theamountofelectrosurgicalcurrent(powersetting)necessarytoperformasurgicalprocedureisafunctionofelectrodesurfacearea(sizeandshape).Thereisathresholdbelowwhichitwillnotwork,thatistosay,aminimumsetting.ItisNOTlikeastovewith“simmer”,“medium”and“high”andcannotbedialedbelowtheminimumthresholdsettingandstillcutorcoagulate.

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3Surgicaltechniqueisaverysignificantfactorinclinicalefficacywhenusingelectrosurgery.PracticeontestmediabeforeusingtheVETROSON®V-10inclinicaluseonpatients!

4AdjustingRFpowersetting(titratingthedose)

• Waytoolow,nocuttingjustcoagulationburn• Toolow,dragging,tissueadheringtoelectrode

• Justright:pressurelesssmoothcleancutting• Toohigh,sparking,proteindepositsonelectrode• Waytoohigh,sparking,charring,carbondepositsonelectrode

NOTE:theflatsideofR71andR72lancetmaybeusedeffectivelyforcoagulation

RFPowerInitialSettingsbipolar(subjecttosubsequentadjustment)

coagulation bipolarforceps 4½to5 coag

indication electrode RFpower waveform

incision<2mm M-1,M-10,M-F11 3to3.5 Fine(Filtered),Normal(FullyRectified)

incision>3mm M-1,M-10,M-11 4to4.5 Fine(Filtered),Normal(FullyRectified

ablation M-1,M-10,M-11 2to21/2 Fine(Filtered)

ablation M-61 2to21/2 Fine(Filtered)

ablation M-51 31/2to4 Fine(Filtered)

planning M-33 5 Fine(Filtered),Normal(FullyRectified)

planning M-34 6 Fine(Filtered),Normal(FullyRectified)

coagulationhard M-51 6to7 coag

coagulationsoft M-51 7 coag

incision M-71,M-72 6to8 Fine(Filtered),Normal(FullyRectified)

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Electrodes

OptionalElectrodes

Number Description

M-10 Finewireincision;straightshaft

M-61 Fineneedle;incision,ablation,fulguration

M-62 Pointedtipfulguration

M-71,M-72 lancet

Number Description

M-1 Finewireincision;adjustabledepth;angledshaft

M-11 Finewireincision;angledshaft

M-33 5mmloop

M-34 10mmloop

M-51 1.5mmcoagulationball

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ElectrodeHolderBlock

The2½”x2½”plasticelectrodeblockholdsupto25electrodesandmaybeusedduringsurgeryasaholder

ElectrodeandHandpiecesterilization

Steam autoclave at 270°F(132°C)for15minutes.Thenosecapshouldberemovedduringautoclave.Coilthecordlooselywhenplacinginanautoclavebag.Allow15minutescoolingtime.FDAdoesnotrecognizechemicalsterilizationasadequateforelectrosurgery.ElectrodehygieneTheactivemetalportionsofelectrodes(boththetissuecontactareasandthepartheldinthehandpiece)mustbecleanandfreeofoxidesandproteindepositsinordertoelectricallyconductelectrosurgicalcurrent.Theseareasmaybepre-cleanedpriortoautoclavewithaquaternarydisinfectantandscrubbedwithasuitablemediasuchasScotchbrite©“maroon”pads.Theelectrodespre-cleanedwithdisinfectantshouldberinsedafterwordspriortoautoclave.Donotsoak!DispersivegroundpadhygieneThegroundpadmaybecleanedwithasuitablequaternarydisinfectant.Donotsoakthegroundpad!Thegroundpadmaybesteamautoclavedat270oF(132oC)for15minuteswitha15minutedryingtime.Ifautoclaving,thepadshouldbelooselywoundupwithalayerofgauzetoallowsteamtoreachtheentiresurfaceofthecoiledpad.Dispersivegroundcable,bipolarcableandbipolarforcepsThesearealsoautoclaveable.Likethehandpieceshouldbecoiledlooselyintheautoclavebag.Steamsterilizeat270oF(132oC)for15minuteswitha15-minutedryingtime.Likeelectrodesanddispersivepad,theseitemsmaybepre-cleanedwithaquaternarydisinfectantandrinsedpriortoautoclave.Donotsoak!Gassterilizationhasnotbeeninvestigatedfortheaboveproductshencenorecommendationcanbemade.Dryheatwilldamageelectrodes,cables,andgroundpad.

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Dispersivegroundpadplacement

Thisaspectofelectrosurgeryisessentialforsuccessfulclinicaluse.

Thedispersivegroundpadisacapacitivetypeanddoesnotrequireanydirectelectricalcontactwithbareskinandwillworkthroughfur.Noadhesivesorgelsareneededorused.

Generalrulesare

• Insurethattheentireareaofthedispersivegroundpadiscoveredbythepatient• Placeoveralargewellvascularizedmusclemass• Placeasneartothesurgicalsiteaspractical

Theleastfurryareasofthepatient’sanatomyarebetter;forexample,insidethethighonlargedogs,onthehaunchesforequineandbovine.Thepatientindifferentplatemaybeheldinplacewithlooselywrappedgauze.Thepatientindifferentplateisflexibletoconformtobodycontoursformaximumcoverage.

Precautions

Electrosurgeryuseshighradiofrequencyelectricalcurrentwhichisinherentlydangerousunlesshandledproperly.Pleasefollowtherecommendationsforsafe,effectiveuseandpositiveclinicaloutcomes.

Fireandexplosionhazard:

• DONOTusewithflammableanesthetics!• Allowalcohol-basedastringentstocompletelydryandevaporatebeforeusingelectrosurgery.• Donotusewithoxygenornitrousoxide!DiscontinueO2orN2Oduringelectrosurgery!Re-establish

afterwards.• DonotallowO2orN2Otopoolunderasurgicaldrape!• RemovecottonorgauzefromcavitieswhereO2orN2Oarepresentbeforeelectrosurgery!Replace

afterwards.

Pacemakersandotherimplantedelectricalmedicaldevices:

• Alwaysconsulttheimplanting/referringphysicianbeforeusingelectrosurgery(patient,operator,orstaffpersonnel).Generallyspeaking,pacemakersareRFshieldedandsafeforusewithelectrosurgery.Caution:theonlywaytoknowistoasktheimplantingphysician.Someotherimplanteddevicesmaynotbeshieldedorsafe;alwaysask!

Smoke:electrosurgicalsmokeisvaporizedtissuecellcontents.FDAandCDCregarditasamildcarcinogenifinhaledsufficientlyoverextensivetime,therefore,theuseofasuitablesmokeevacuatorisverystronglyadvised.Virusmaybepresentinelectrosurgicalsmoke.Ifapatientisknowntohaveactiveviralinfection,takeadditionalmeasuresforsurgeonandstaffrespiratoryprotection.

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Iftheelectrosurgicalgeneratorappearstolosepower:

DONotturnupRFpowertoadangerouslevel!Firstdothis:

• Checkthedispersivepadforpositionandfirmconnectiontothegenerator• Besurethewrongcurrentqualityisnotselected(i.e.,COAGinsteadofFINE(Filtered))• Besuretheproperpowersettingisset(seeinitialsettings)• Besurethattheelectrodeiscleanandnotcompromisedbyproteindepositorcarbon• Besurethatcablesareintactandfunctional(substituteasparetoverify)

Metallicinstrumentsorobjects(includesimplantsandamalgams,jawwiring,orthopedicbraces)Electrodecontactwithametalinstrumentorobjectwillmaketheobjectanextensionoftheelectrodeandelectrosurgicalcurrentwillentertissuewherevertheobjectisincontactresultinginburns.

• Avoidcontactwithmetalobjectsinthesurgicalfield!• DONOTallowelectrosurgicalcablestocoilaroundmetalobjects!(magneticinductionwillcause

electrosurgicalcurrenttobegeneratedintheobject)NOTE:“buzzingthehemostat”istheobviousexceptiontotheaboveElectrodeheatIntenseintracellulartissueheatwillheattheelectrodewhichwillremainhotafterelectrosurgery.

• Withdrawtheelectrodefromthesurgicalsitecautiouslytoavoidtissuecontact.• Allowadequatecoolingtimebeforehandlingtheelectrode.

Inadvertentactivation

• Neverleaveahandpieceorbipolarforcepsrestingonapatient!Alwaysstowinproperholder.• BesurethatfootpedalisinsightandyellowRFindicatorisoffwhenchangingelectrodesorbipolar

forceps.Bone

• NEVERcontactexposedbonewithmonopolarelectrosurgeryo ContactwithmonopolarelectrosurgicalcurrentWILLnecrotizethebonenutrientforamenand

subsequentinjurywillbeamatterofdegreeo Usebipolarcoagulationnearoronexposedboneo Donotcoagulateonthedentalpalatewithmonopolarelectrosurgery(seeabove)

GeneralhintsandadviceAnesthesiaisnecessaryforelectrosurgery.

• TurnontheV-10andallowstabilizationtocompletethenactivatetheV-10brieflytoverifyitis

operationalbeforeadministeringanesthesia.

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AvoidoverstressingtheV-10.

• Observe10secondsofoperationfollowedby20secondsde-activecoolingtime• Donotoperatethemodeswitchwiththeunitactive

Electricallysafesetup

• UseonlywithhospitalgradeNEMA15orNEMA20outlets• Donotdefeatthegroundpinonthemedicalgradepowercord• Donotuseextensioncords

Easiercleanup

• Placegroundpadinacleandisposableplasticbag• Usehandpieceprotectorsheaths(NOTasubstituteforautoclaving!)

Avoidfailuresduringsurgery(pro-activeprevention)

• Handpieces,dispersivecable,andbipolarcablehaveafiniteservicelife.o Routinelyreplacetheaboveonabi-annualschedule

• Alwayshaveaspareautoclavedhandpiece,dispersivecable,andbipolarcableonhandInspecthandpieces,cables,andforcepsforvisibleflawsbeforeautoclave

• Routinelyinspectforbaremetalshowingwhereitshouldnotbe• Replacefaultyitems!Donotattemptrepair.

Handrestfordelicateprocedures

• Fordelicateproceduresestablishahandrestonthepatient• Doacoupleof“practicestrokes”withoutactivatingtheunitbeforeproceeding

Oculoplastic

• ALWAYSusecornealshields!Dental

• AlthoughintendedforgeneralveterinarysurgerytheV-10isverywellsuitedfordentalCoagulationhintsandadvice

• Monopolar“hard”coagulationiswhentheballisplacedincontactwithtissuethentheunitactivatedo Usedfordeeppenetrationofheavybleedso Usedfordesiccationorablationoflesionso Willhavesignificantcollateraltissuedenaturing,leavescicatrix

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• Monopolar“soft”coagulationiswhentheunitisactivatedfirstthentheballbroughtintocontactwithtissue

o Usedforsuperficialcoagulationo Relativelyshallowtissuepenetration,minimalcollateraltissuedenaturing,cicatrix

• Monopolarcoagulationisineffectiveinwetorbloodyfields

o Usespongesasrequiredtoclearthefieldbeforemonopolarcoagulation

• Ballelectrodesizeo The1.5mmballtakestheleastRFpowertooperateo Ifpowerissettoohighthe1.5mmballcanablatetissueinsteadofcoagulateo The3mmballis“generalpurpose”o The5mmballtakesaveryhighRFpowersettingandisbestsuitedto“soft”coagulation

• Bipolarcoagulationo TakeslessRFpowerthanmonopolarcoagulationo Effectiveinwetorbloodyfieldso Maybeusedlikeamonopolarballbyholdingthetipsapart

§ Blunttipsworkbestforthis§ Maybeusedas“soft”or“hard”inthismanner§ Seepage5forlargeareacoagulation

ResolvingoperationaldifficultiesUNIT Unit fails to turn on.

• Verify that the electrical outlet is functional by plugging in another appliance known good. • Verify that power cord is firmly seated in the appliance entry.

Unit turns on OK, timing indicator goes out OK, but unit will not activate when pedal is pressed.

• Verify that the foot pedal connector is attached and seated properly. • Verify that the foot pedal cord is not damaged. • Check foot pedal for obvious faults: does it “click” when pressed?

Sometimes depressing the foot pedal activates the unit, sometimes not.

• If the foot pedal is depressed on the very extreme corner it may not “click”. Be sure to step on it as fully as practical to avoid this annoyance.

NOOPERATIONThe yellow “active” indicator comes on OK, but I get no cutting.

• Verify that the “Flexi-plate” dispersive plate is plugged in at the chair and at the unit.

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• Verify that the electrode is fully seated and insulation is not caught in the chuck. • Verify that the dispersive cable is undamaged and functional. • Verify that the hand piece cable is undamaged and functional. • Electrodes must be clean

POOROPERATION

• Verify that proper initial power setting for the electrode selected is established. • Verify that COAG has not been inadvertently selected for an incision or excision. • Verify that heavy, thick fur is not adversely affecting dispersive efficiency • Verify dispersive plate positioning

Warrantyisfor5yearsfromdateofsalefortheunit.Electrodes,cables,groundpad,andbipolarforcepsfortwoyearsfromdateofsale.RepairsCallSummitHillLaboratoriesforaReturnAuthorizationnumber(RAnumber)BEFOREsendinginaunitforservicesoastoassureproperhandlingandpromptresponse.Haveyourunitserialnumberreadywhenyoucallanddescribeyourproblem.Handwrittendescriptionsmaybepackedwiththeunit.Toavoidshippingdamagetheunitshouldbereturnedinitsoriginalpackaging.Iftheoriginalpackagehasbeendiscarded,pleaserequestonefromSummitHillforreturningyourunitforservicewhencallingforRAnumber.CAUTION:foryoursafety!TheVETROSON®V-10devicecontainsnouserserviceableparts.

• Neveropentheunityourself.• Neverattemptmodificationofthedeviceoranyaccessory.• UseonlySummitHilllaboratoriessparesandaccessories

o DonotusegenericsubstitutesSUMMITHILLLABORATORIESTintonFallsBusinessCenterOneSheilaDriveTintonFalls,NJ07724Voice7329330800FAX7329330055sales@summithilllaboratories.comVisitwww.summithilllaboratories.comforreplacementitemsalsoforavailableelectrodesandbipolarforce

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