Martin maxium & maxium Beamer Operating Instructions
V 2.0
73
•
Be sure to protect installed cylinders from toppling over!
The maxium Cart provides special
straps for this purpose.
•
Never open the angle valve as long as no pressure reducer has been connected!
•
Use only argon gas as a working gas!
Technically, the pressure reducer can also be con-
nected to other cylinders containing so-called special gases such as carbon dioxide! Therefore,
verify that the cylinder you are going to use really contains argon and not another type of gas.
This can be recognized by the gas cylinder’s banderole or label (lettered "ARGON").
Note that while inert-gas coagulation systems using helium are also available on the market, he-
lium cannot be used with the maxium Beamer because the gas flow control has been calibrated
for argon! Although it would be technically possible to connect a helium gas cylinder, using he-
lium would mean a much higher actual gas flow rate than indicated!
•
Use only genuine Martin pressure reducers!
Note that the system’s safety and proper func-
tioning are guaranteed only if you use a genuine Martin pressure reducer!
10.7.4
Embolism und Emphysemas
When gas is blown into the surgical site, there is always a danger that the gas enters dissected
blood vessels as well – which poses a gas embolism hazard. While it is true that, unlike air or oxy-
gen, argon gas does not cause blood clotting, argon gas bubbles can nonetheless obstruct (or
even completely stop) the blood flow in some regions when they are allowed to enter the arterial
circulation and travel through the increasingly thin branches of those vessels. Moreover, if the gas
outlet at the tip of the applicator is directly applied to the tissue, there is a danger of argon being
injected into the tissue underneath (causing emphysema). And in the case of tissue structures
where a conjunctiva covers a closed tissue layer, or where several skin layers are involved, argon
gas can get in between these layers, thus leading to an unnoticed separation of these layers with
consequential inclusion of larger quantities of argon gas.
To prevent this, observe the following:
•
Never apply the applicator’s gas outlet directly to the tissue!
If the beam exiting from the
gas outlet exhibits poor ignition properties, it may be necessary to increase the output power on
the maxium HF unit or replace the applicator’s tip (due to starting electrode tip burn-off).
•
Never use the maxium Beamer for the hemostasis of major vessels!
If major vessels have
been dissected, the blood flow cannot be reliably staunched with the maxium Beamer because
the latter has a purely superficial effect. Such bleeding must therefore be treated by conven-
tional monopolar contact coagulation (using hemostatic forceps if required).
•
Wherever possible, the applicator should not be held perpendicularly to the tissue. It is prefer-
able rather to hold it at an angle of 30 to 60 degrees because this clears the surgical site, thus
ensuring a good view.
