The radiofrequency generator CURIS® made by Sutter Medizintechnik in Germany relies on the 4 MHz technology: It is gentle to the tissue and effective for coagulation, for lesions and for cutting. The patient trauma is reduced to a minimum.
CURIS® 4 MHz Technology
The higher the frequency, the less the resistance of biological tissue to electromagnetic fields – up to the point where the cell membranes are capacitively coupled. This is exactly what happens with the 4 MHz produced by the CURIS® (both in the monopolar and the bipolar modes). The electromagnetic fields are active in the tissue cells – not as is the case with conventional electrosurgical units, between the cells. As a result energy is administered gently and in a highly focussed fashion. For example precise monopolar cuts are possible while lateral heat damage is kept to a minimum.
CURIS® p3™ Technology
p3™ is active in all coagulation modes of the CURIS®. Radiofrequency energy is delivered in small packages of about 50 per second.
Due to the pulsed power output, there are very short breaks between the individual packages. The tissue has the time to absorb and distribute the energy and will generally be less traumatised. Highly-focussed, yet gentle coagulation with
minimal thermal damage is possible. The p3™ process is, of course, AutoRF™ controlled.
Precision thanks to AutoRF™
The AutoRF™ function is the main control feature of the CURIS®. It responds to tissue impedance in all modes and controls and adjusts the power output according to tissue resistance.
The AutoRF™ function of the CURIS® will tailor the energy output (if need be even cut off or drive to the chosen maximum) in order to to ensure reproducible surgical results during cutting or coagulation.
Many Applications - One Unit
CURIS® Versatility in ENT
RaVoR™: Radiofrequency Volume Reduktion of the turbinates, soft palate, tongue base, etc. is an interstitial (i.e. „blind“) application: The surgeon has no visual feedback; for the desired outcome he solely relies on the system. A generator monitoring the tissue and adjusting power is a must. AutoRF™ is an intelligent mode with impedance control that will tailor the power output of the CURIS® to the tissue condition. As soon as the right size of a lesion has been achieved, the CURIS® generator will automatically stop the activation (AUTO STOP mode) and give an acoustic signal.
If desired, an acoustic feedback function (AUDIO FEEDBACK) can be activated for additional safety. While a lesion is created, the change in tissue condition is signalled according to a predefined pitch: The further the lesion progresses, the higher the activation sound.
This mode may also be used to increase the patient’s comfort. He will be able to listen in and follow what happens inside his tissue.
CURIS® in Plastic and Aesthetic Surgery
allows the tissue to heal with minimal postoperative pain and scarring.The degree of haemostasis is determined by the surgeon. It goes without saying that the CURIS® produces clear, clean cuts. This only works when the energy delivered is highly focussed and there is minimal lateral heat damage. A frequency of 4 MHz and AutoRF™ combine to create a homogenous electromagnetic field. For the unit to adjust to ever changing conditions during cutting skin, fat and muscle in one stroke, active performance control with AutoRF™ is able to ensure reproducible results.
Best possible coagulation results according to the doctor’s requirements in two bipolar modes. For instruments with wider tips of 1 mm and more, the MACRO mode is ideal. The advantage of fine instruments – their precision – is enhanced by the PRECISE mode, which can be adjusted in steps of 0.5 watts. Its gentleness and characteristics guarantee safe coagulation results during subtle interventions and near sensitive structures.
CURIS®basic set with single-use patient plates:
CURIS® radiofrequency generator (incl. mains cord, user‘s manual and test protocol)
Footswitch two pedals for CURIS® (cut & coag), 4 m cable
Bipolar cable for CURIS®, length 3 m
Monopolar handpiece (pencil) cut & coag, shaft 2.4 mm, cable 3 m
Cable for single use patient plates, length 3 m
Safety patient plates, single use, packing 5 x 10 pcs. (not shown)
Optional model CURIS® basic set with re-usable patient plate
Is the CURIS® system suitable for sleep surgery?
For sleep surgery in particular the CURIS® system offers fully automated tissue impedance control (AutoRF™) with an automatic cut-off and audio feedback indicating the tissue condition during activation. The CURIS® 4 MHz operating frequency delivers highly focused surgical effects (cutting and coagulation) with minimal heat spread and the highest level of control. The CURIS® is an all-in-one ENT surgery device: It is able to perform sleep surgery, do any cutting and coagulating necessary in ENT, and in plastic surgery and dermatology as well. It can even replace the laser.
Can a Sutter generator be used without a patient plate?
Some competitors recommend to work without a return/patient/antenna plate and sell this proposition as a major feature of radiofrequency. Technically speaking any generator can be operated in this manner. However, there is a MAJOR SAFETY CONCERN involved for the patient if a generator is operated without a return plate in monopolar mode! And there are ALWAYS good reasons to USE A RETURN PLATE:
Current applied to tissue through an active electrode has to "find its way back" to the generator. If it is not "collected" by the return plate, it will "look for the easiest alternative way out". In that case anything that is earth-referenced, e.g. surgical equipment, furniture, etc., can become the alternative path. The technical term used is capacitive coupling. Touching an endoscope, a metal part of the chair or the operating table may result in burns! Such burns can occur on the skin, but also inside the body, even in areas far away from the surgical site, and they can DAMAGE VITAL STRUCTURES! Especially the office setting, when patients are awake and tend to move, thus changing the current path, can be dangerous.
The latest generator technology, e.g. the Sutter CURIS® 4 MHz radiofrequency generator, offers an additional safety feature to minimize the danger of burns. It constantly monitors the return plate (when a split patient plate is used) and immediately cuts off power delivery and gives an alarm signal when the patient plate becomes loose. Surgery can only be resumed when the return plate is properly re-attached.
To create the capacitive coupling effect, energy is needed. Working without a patient plate always requires more power than needed for the surgical effect. More energy can potentially cause more damage to the tissue and can cause burns more easily.
A properly attached patient plate closes the circuit and makes tissue effects homogenous throughout the procedure. Without the patient plate, cutting and coagulation effects may vary, depending on the patient's position, clothing, etc.