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Coblation^® technology was designed and patented by ArthroCare Corporation. Derived from “controlled ablation”, the name refers to the non-heat driven process of surgically dissociating soft tissue by using bipolar radiofrequency energy to excite the electrolytes in a conductive medium, such as saline solution, to create a precisely focused plasma field. Energized particles, or ions, in the plasma field have sufficient energy to break, or dissociate, organic molecular bonds within soft tissue at relatively low temperatures.^1,2 This enables Coblation devices to volumetrically remove target tissue with minimal damage to surrounding tissue. Coblation devices can also provide hemostasis and tissue shrinkage capabilities.

A cool technology

Most surgical devices, such as lasers and traditional electrosurgical tools, use imprecise heat-driven processes to remove or cut tissue.  In contrast, Coblation-based devices are designed to operate at a relatively low temperature to gently dissolve and/or shrink target tissue with minimal thermal damage to surrounding healthy tissue.  Because radiofrequency current does not pass directly through tissue during the Coblation process, tissue heating is minimal. Most of the heat is consumed in the plasma layer, or in other words, by the ionization process. These ions then bombard tissue in their path, causing molecular bonds to simply break apart and tissue to dissolve.

	Coblation-based Devices	Conventional Electrosurgical Devices
Temperatures	40°C to 70°C	400°C to 600°C
Thermal penetration	Minimal	Deep
Effects on target tissue	Gentle removal, dissolution	Rapid heating, charring, burning, cutting
Effects on surrounding tissue	Minimal dissolution	Inadvertent charring or burning

Output control

The ArthroCare electrosurgical controller and other electrosurgical power sources have unique differences from both electrocautery and conventional electrosurgical systems. Although all of the controllers are radiofrequency controllers, the ArthroCare controllers use a unique output which allows them to deliver the right amount of power for creating a plasma field. The amount of power delivered is determined by intensity of the field and is adjusted based on the local environmental condition. The electrical resistance of the circuit between the active and return electrode is a combination of the electrode/fluid interface, the vapor layer surrounding the electrode, the saline, and the environmental conditions during the procedure.

ArthroCare's unique waveform has a sharp leading edge that requires little time to generate a plasma discharge; thereby allowing more time, per half cycle, for active ablation, which is the desired tissue effect. By contrast, a higher frequency sine waveform has a more gradual ramp that requires more time to reach the maximum voltage required to create a discharge for tissue ablation, allowing less time to effectively treat tissue.

Broad applicability

Coblation technology has been used in millions of surgical procedures worldwide within the fields of arthroscopy, spine and neurology, otolaryngology, urology, gynecology, and laparoscopy/general surgery. Additional surgical applications continue to be explored.

References

1. Woloszko J, Stalder KR, Brown IG. Plasma characteristics of repetitively-pulsed electrical discharges in saline solutions used for surgical procedures. IEEE Transactions on Plasma Science. 2002 Jun; 30(3):1376-83.
2. Stalder KR, Woloszko J, Brown IG, Smith CD. Repetitive plasma discharges in saline solutions. Applied Physics Letters. 2001 Dec 31;79(27):4503-5.