Blades in order from least to most aggressive
- Turbowhisker
- Turbotrimmer
- Synovator
- Cutter
- Full Radius
- Full Radius Elite
- Razorcut
- Incisor
- Incisor Plus
- Incisor Plus Elite
- Bonecutter
Also have Orbit Rotatable blades - Convex/Concave cutting window
Platinum Blades and Benefits
- Platinum Synovator
- Platinum Full Radius
- Platinum Flyer
- Incisor Plus Platinum
- Bonecutter Platinum
Tighter tolerances (better vacuum)
Fortified Alloy (consistently sharp)
Burrs
Abrader
Shielded Abrader
Acromioniser
Helicut
Notchblaster
Acromioblaster
Stonecutter
Dyonics PowerMax Elite - key messages
No vibrations (White Thumb)
Torque = 32oz/in
(Mini = 22oz/in)
Lever Suction control
Blade family auto recognition
Window lock
Competitors
Stryker - Crossfire 2
Conmed - D4000
Dyonics Power II (D2) Oscillate modes
Mode 1
Time based (RPM within time)
0.3 - 1.0s
Mode 2
RPM based (Number of revs before change direction)
1 or 2
More aggressive
Dyonics Power II (D2) - how to set Window lock?
- Hold Osc on handpiece
- Footpedal
- Lock icon on screen
(Unique to S+N)
Coblation Equation
NaCl + H20 + energy =
OH- and e- (tissue breakdown)
O2, H2 (gas bubbles)
Excited Na (glows orange)
Cl
Coblation Technology:
1. What is Coblation
2. What is Plasma?
3. What size is Plasma bubble?
4. How is it formed?
- Controlled Ablation using Glow Discharge Plasma
- 4th State of Matter (energised gas)
- 100-200um (microns)
- Current to electrodes
- vapor layer forms
- energy into vapor layer which forms plasma
- plasma breaks water into free radicals
Coblation Frequency:
S+N vs competitors?
why is low frequency better?
Bone damage?
100 kHz (low)
Stryker 180kHz
Mitek 288kHz
Low Frequency:
= Tissue provides high resistence, prevents conduction
= low tissue penetration
= PRECISE
Knee cartilage 500um
Plasma bubble 100-200um
= no damage to bone
Coblation Wavelength
Unique waveform
- sharp leading edge with long tail
- competitors have more frequent heat peaks
Coblation Power Curve
Levels 1 to 5 = Thermal
Tissue shrinkage
Levels 5 to 9 = Chemical
low/no heat
Advantages of Coblation
Clinical Benefits
1. Operates at lower temps that other RF based tech
2. 100-200um Precise with minimal thermal damage
3. Avoids repeated instrument changes
4. Smoother anatomical surfaces
Economical Benefit
1. Improved efficicency / less time
Werewolf Controller:
3 Key messages
- Performance (FLOW IQ)
- Versatility (optimal wand performance of different tissue)
- Confidence (Improved Ambient)
Operating modes of Werewolf Controller
LO - chondroplasty, meniscus/labrum finishing
MED - Meniscus / Labrum
HI - ACL stump, SAD, fat pad
VAC - Rinse & remove tissue
Coag - Hemostasis
What is FLOW IQ?
Real time flow and energy regulation which adjusts for:
1 - Tissue Type
2 - Tissue Contact
3. Plasma Quality
= CONSTANT RESECTION
FLOW 50 / 90 Wands:
Buttons?
Tip size?
3 buttons:
Yellow = Ablation
Blue = Coagulation
Black = Change level
Black (hold) = VAC
2.95mm tip
Wands / Blades for ACL
Incisor Plus Platinum
ASMV50 or Flow 50
Wand / Blades for Meniscus
Platinum Synovator
ASMV50 or Flow 50
Wand / Blades / Burs for SAD
Incisor Plus Platinum
Acromioniser Elite
ASTV90 or Flow 90
Wand / Blades for RCR
Platinum Bonecutter
ASTV90 or Flow 90
Visualisation Components
Scope
Coupler
Light Cable
LENS Camera Head
LENS Console
iPad
Monitor
Pump functions (3)
- Distend the joint
- Flush the joint
- Control bleeding
All whilst maintaining stable, set pressure
Definition of Flow Rate and what it does
Amount of fluid that passes a given point in a given time
- Keeps joint clear
- Helps blades to cut
(litres per min)
Two issues of wrong pressure
Pressure too high - EXTRAVASATION (fluid into surrounding tissues)
Pressure too low (eg shavers) distended joint will collapse
